Environmental Remediation Action Report

1. Project Information

Project Name Project Number Site Location Date

2. Site Description

Site Overview Known Contaminants Source(s) of Contamination

3. Remediation Objectives

Objectives

4. Remediation Activities

Summary of Action(s) Taken

Date	Activity Description	Personnel/Contractor

5. Monitoring and Results

Sampling/Testing Performed Results Summary

6. Remaining Issues or Concerns

Ongoing Issues Recommended Next Steps

7. Attachments

List of Attached Supporting Documents

Prepared by

Name Title Organization Date