APPENDIXA-DEVELOPERCERTIFICATION
INTHEMATTEROFTHE:
[InsertSiteName,:DEVELOPER
ProgramInterestNumber(PreferredID)]:CERTIFICATION
AND:
[InsertNameofPerson]:
______,
NameofAuthorizedIndividual
______
AuthorizedIndividual'sTitle
______
NameofPerson
______
AddressofPerson
herebycertifies,onbehalfof[insertnameofperson],thatheorsheisauthorizedtomakethisbindingCertificationforthe[describeheretherealpropertythat[insertnameofperson]isremediating,includinganynamebywhichtheSiteisknown,thestreetaddress,allblocksandlots,themunicipality,countyandtheDEPprograminterestnameandprograminterestnumber(preferredID)][(theSite)],and,withregardtothatSite,[insertnameofperson]furthercertifiesasfollows:
1.Ifpersonisanownerofthesite,oraprospectivepurchaserofthesite:[Insertnameofperson]insertoneofthefollowing:
purchasedtheSiteon[insertdate];
acquiredtitletotheSitebydeviseorsuccessionon[insertdate];
intendstoacquiretheSiteafterthedateofthisCertification.
2.Ifpersonisanownerofthesite,insertoneofthefollowingunlessthepersonacquiredthesiteonorafterJanuary6,1998andenteredintoanoversightdocumentwiththeDepartmentpriortoacquiringownershipoftheSite:
IfpersonacquiredtitletotheSiteonorafterSeptember14,1993,insertthefollowing:
[Insertnameofperson]hasundertaken,atthetimeofacquisition,allappropriateinquiryintothepreviousownershipandusesoftheSite,includingtheperformanceofapreliminaryassessmentandasiteinvestigation,ifnecessarypursuanttoN.J.A.C.7:26E. Acopyofwhichisattachedhereto. See,N.J.S.A.58:10-23.11gd(2).
IfpersonacquiredtitletotheSitepriortoSeptember14,1993,insertthefollowing:
Atthetimeofacquisition,[Insertnameofperson]undertookallappropriateinquiryonthepreviousownershipandusesoftheSitebasedupongenerallyacceptedgoodandcustomarystandards,and,asresultofthatinquiry,didnotknowandhadnoreasontoknowthatanyhazardoussubstanceshadbeendischargedattheSite. AfteracquiringtitletotheSite,[Insertnameofperson]submittedtotheDepartment,on[insertdate],apreliminaryassessmentreportpreparedpursuanttoN.J.A.C.7:26E-3.2,and,ifnecessarypursuanttoN.J.A.C.7:26E-3,asiteinvestigationreportpreparedpursuanttoN.J.A.C.7:26E-3.13. Acopyofwhichisattachedhereto. See,N.J.S.A.58:10-23.11gd(5).
3.IfthepersonacquiredtitletotheSiteonorafterJanuary6,1998,insertthefollowing:
[Insertnameofperson]has:
a. Within10daysafteracquiringtitletotheSite,agreedinwriting(acopyofwhichisattachedhereto)togivetheDepartmentaccesstotheSitetooverseetheremediationandtoperformanyremediationthat[insertnameofperson]doesnotperform;and
b. Within30daysafteracquiringtitletotheSite,commencedremediationoftheSite,includinganymigration,pursuanttoaDepartmentoversightdocumentexecutedon[insertdate,whichmustbepriortodateofacquisition]andispresentlyincompliancewithalloftheDepartment'sremediationrequirements.
4. [InsertthefollowingifthepersonexecutingthisCertificationisanowneroftheSiteandhasdiscoveredadischargeattheSite.] Concerningdischargesatthesitewhichoccurredpriorto[insertnameofperson]'sacquiringtitle,whereapplicable,totheSite:
a. [Insertnameofperson]discoveredthedischargesattheSiteon[insertdate];and
b. [Insertnameofperson]reportedthesedischargestotheDepartmenton [insertdate]via[insertoneofthefollowing:
telephonecalltotheDEPHotline,
writtendocumentation,or
describeothermeansofprovidingtheDepartmentnoticeofthedischarges].
5. [Insertnameofperson],atanytimeuptothedateofthisCertification:
a. Hasnotdischarged,attheSite,anyhazardoussubstanceasdefinedpursuanttoN.J.S.A.58:10-23.11b,hazardouswasteasdefinedpursuanttoN.J.S.A.13:1E-38,orpollutantdefinedpursuanttoN.J.S.A.58:10A-3;
b. Hasnotbeeninanywayresponsible,pursuanttoanylaw,foranycontaminantatoremanatingfromtheSite,orcontaminationthathasemanatedfromtheSite,otherthanbyacquiringownershipoftheSite,ifapplicable,afterallofthedischargesoccurredattheSite;
c. HasnotaggravatedorcontributedtocontaminationatoremanatingfromtheSite,orcontaminationthathasemanatedfromtheSite;
d. Hasnot,asaholderofasecurityinterestinafacilityorundergroundstoragetankfacility,activelyparticipatedinthemanagementofafacilityorundergroundstoragetankfacilityattheSite,asthosetermsaredefinedinN.J.S.A.58:10-23.11aetseq.;
e. HasnotnegligentlycausedanewdischargeattheSite,afterthedateof[insertnameofperson]’s foreclosureonasecurityinterestintheSite,pursuanttoN.J.S.A.58:10-23.11g.6.e(1);and
f. Isnotatthetimeofthiscertification,andhasneverbeen,anowneroroperatorofanindustrialestablishmentattheSitepursuanttotheIndustrialSiteRecoveryAct,N.J.S.A.13:1K-6etseq.
6. [Insertnameofperson]isnotacorporatesuccessorto,affiliatedwith,orotherwiserelatedtoanypersondescribedbelowsuchthat[insertnameofperson]wouldbeliableforthe contaminationotherthanbyacquiringtitletothesite:
a.Anyentitythatthe[Insertnameofperson]hasreasontobelievehasdischargedattheSiteanyhazardoussubstanceasdefinedpursuanttoN.J.S.A.58:10-23.11b,hazardouswasteasdefinedpursuanttoN.J.S.A.13:1E-38,orpollutantdefinedpursuanttoN.J.S.A.58:10A-3;
b.Anyentitythat[Insertnameofperson]hasreasontobelieveisinanywayresponsible,pursuanttoanylaw,forcontaminationatoremanatingfromtheSite,orcontaminationthathasemanatedfromthatSite,otherthanbyacquiringownership,ifapplicable,oftheSiteafterallofthedischargesoccurredattheSite;or
c.Anypersonthat[Insertnameofperson]hasreasontobelieveisliable,pursuanttoN.J.S.A.58:10-23.11g,forcleanupandremovalcosts,asthatphraseisdefinedatN.J.S.A.58:10-23.11b,fortheSite.
7. [Insertnameofperson]agreesthatuntiltheremediationiscomplete,[insertnameofperson]isunderacontinuingobligationtoinforminwritingtheNewJerseyDepartmentofEnvironmentalProtection,within30calendardaysafteranyoftheabovefactsorcircumstanceschangeandthedateofsuchchange.
8. [Insertnameofperson]isfamiliarwiththeSiteandwithallmattersaddressedinthisCertification.
9. Icertifythattheforegoingstatementsmadebymearetrue. Iamawarethatifanyoftheforegoingstatementsmadebymearewillfullyfalse,Iamsubjecttopunishment,andthatIwillalsoforfeitdeveloperstatus,forthepurposesoftheDepartment’soversightcostformula,inthatevent.
[TypeorPrintFullNameofPerson]
Dated:______By:______
SignatureofAuthorizedIndividual
[TypeorPrintNameandTitleofAuthorizedIndividual]
Dated:______Witness:______
SignatureofWitness
[TypeorPrintNameandTitleofWitness]
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