NJDEP Bureau of Environmental Measurements and Site Assessment

Monitoring and Maintenance Checklist

Inspection Date: _______________ Inspection Location: ___________________________

Weather Condition: ______________________________ OUTSIDE Temperature: ________

Note: For all non Sub-slab Depressurization Systems (SSDS) locations skip to question 4.

(Circle one)

1. Was the Subslab Depressurization System (SSDS) operating upon arrival? Yes / No

If “No,” explain below why the system was not running, efforts taken to restart the SSDS and if the system was operational when leaving. If successful in making the SSDS operational, complete the remainder of the checklist.

2. Were all vapor extraction point vacuum readings within 20% of the Initial Commissioning Values? Yes / No

If “Yes,” no subslab probe vacuum readings are necessary (skip to step 4).

If “No,” subslab probe vacuum readings must be collected and discuss potential reasons for the changes in vacuum readings.

3. If measured, were all subslab probe vacuum readings greater than 0.004 inches of water? Yes / No

If “Yes,” the SSDS is deemed still effective and the vacuum readings taken during this inspection are now the new baseline readings for future 20% variation calculations. (see Vapor Intrusion Technical Guidance (VITG) Section 6.5.1)

If “No,” system must be adjusted/amended and the SSDS re-commissioned (See VITG Section 6.4.2). Discuss adjustments and amendments below:

4. List below all pertinent observations and actions taken during this Inspection:

i.e., sagging/damaged pipes, construction changes to building that may affect the system, pipe leaks that may need smoke test, is building still vacant, has occupancy zoning changed (i.e. commercial to residential), are non-SSDS engineered systems still functioning as designed etc. Add additional pages as needed.

5. If indoor analytical air samples were taken as part of operation, monitoring and maintenance, were all Indoor Air results below applicable screening levels? Yes / No

Overall Assessment - Is the system/remediation protective? (Circle one) YES / NO

LSRP Name: _________________________________________________

LSRP License #: _______________________

LSRP Signature: _______________________________ DATE: _______________

Monitoring and Maintenance Checklist Page 1 of 2

Ver 1.0 03/26/15