TJ        UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
                                   WASHINGTON, D.C. 20460
                                                                               OFFICE OF
                                                                             SOLID WASTE AND
                                          JAM 9 n Oft*!?                      EMERGENCY RESPONSE
                                         JMIX Ł U ŁU|Q                         OLEM -9200.0-89

MEMORANDUM

SUBJECT:   Transmittal of the Five-Year Review Recommended Template

                                        n     ^-i -jj A
FROM:      James E. Wool ford, Director  yhi~~- ^ 4- C^/i-^C^-
             Office of Superfund Remediairon and Technology Innovation

TO:         Superfund National Policy Managers, Regions 1-10


PURPOSE

The purpose of this memorandum is to transmit the Five-Year Review Recommended Template.  The
Five-Year Review Recommended Template amends Appendix E of the "Comprehensive Five-Year
Review Guidance," OSWER 9355.7-03B-P, June 2001.

The purpose of this guidance for the recommended template is to provide an approach for preparing
Five-Year Review (FYR) reports in a manner that is intended to promote national consistency, to reduce
non-essential information and to decrease repetitiveness in the report. With such an approach, the Office
of Superfund Remediation and Technology Innovation (OSRTI) intends for the template to reduce the
time and cost associated with both writing and reviewing FYR reports. Also, OSRTI expects the
template's application will increase the efficiency and consistency of FYR data entry into the Superfund
Enterprise Management System (SEMS).

As stated in EPA's Comprehensive Five-Year Review Guidance (OSWER  Directive 9355.7-03B-P,
June 2001) on page 1-1, "[t]he purpose of a five-year review is to evaluate the implementation and
performance of a remedy in order to determine if the remedy is or will be protective of human health
and the environment." The 2001 guidance addresses the recommended process for conducting FYRs.

BACKGROUND

OSRTI began working on pilot projects with the Regional programs  in 2011 to streamline the FYR
report. The Superfund Remedial Program Review Action Plan from November 2013 reemphasized the
need to "...provide a 'streamlined' FYR template for national use" to increase efficiency in site cleanup
approaches. The goal of the FYR report streamlining pilots was to explore changes that can be made to
the report to  reduce non-essential information and repetitiveness, while remaining focused on the
information and conclusions necessary to evaluate whether the remedy is or will be protective of human
health and the environment. The results and conclusions of these pilots informed  the development of the
Five-Year Review Recommended Template.
                                   Internet Address (URL) • http://www.epa.gov
            Recycled/Recyclable • Printed with Vegetable Oil Based Inks on 100% Postconsumer Process Chlorine Free Hecycled Paper

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IMPLEMENTATION

Beginning in fiscal year 2017, the Five-Year Review Recommended Template should be used for all
FYRs in the Remedial Program. The Federal Facilities Restoration and Reuse Office is reviewing the
template for potential application at Federal facility sites subject to EPA oversight. For FYRs in the
Remedial Program completed during fiscal year 2016, the use of this template is optional at fund or
private party sites and at the discretion of the region.

The Five-Year Review Recommended Template can be found in PDF and Microsoft Word format on
the FYR webpage: http://www.epa.gov/superfund/writing-five-year-reviews-superfund-sites.

CONCLUSION

If you have any questions, please contact me or have your staff contact Jennifer Edwards of my staff at
edwards.jennifer@epa.gov or (703) 603-8762.
Attachment

cc:     OSRTI Managers
       National Regional FYR Coordinators
       Charlotte Bertrand, FFRRO
       John Michaud, OGC
       Kristin Giacalone, Superfund Lead Region Coordinator, US EPA Region 2
       NARPM Co-Chairs
       Jennifer Edwards, OSRTI
       Cyndy Mackey, OSRE

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                 FIVE-YEAR REVIEW RECOMMENDED TEMPLATE
                                       OLEM 9200.0-89


                        PURPOSE OF THIS RECOMMENDED TEMPLATE

The purpose of this guidance for the recommended template is to provide an approach for preparing Five-Year
Review (FYR) reports in a manner that is intended to reduce non-essential information and repetitiveness in the
report. This recommended approach is designed to:

    •   Reduce time & cost in writing the Five-Year Review
    •   Reduce time & cost in reviewing the Five-Year Review
    •   Increase efficiency and consistency of Five-Year Review data entry into the Superfund Enterprise
       Management System (SEMS)

As stated in EPA's Comprehensive Five-Year Review Guidance (OSWER Directive 9355.7-03B-P, June 2001)
on page  1-1, "[t]he purpose of a five-year review is to evaluate the implementation and performance of a remedy
in order to determine if the  remedy is or will be protective of human health and the environment." The 2001
guidance addresses the recommended process for conducting FYRs.

             RECOMMENDATIONS FOR USING THIS RECOMMENDED TEMPLATE

    •   Regions should consider this recommended template when carrying out Five-Year Reviews.

    •   Some sites subject to FYRs involve complex remedies and include multiple operable units (OUs).
       Suggestions have been made in this recommended template for when to consider organizing information
       by OU in order to simplify the documentation of the FYR. In addition, although an executive summary is
       not included in this recommended template, complex remedies and multiple OU sites may benefit from
       the inclusion of an executive summary to summarize site actions and orient the reader.

    •   This recommended template is meant to serve as a suggestion for the information necessary to document
       the results of the FYR. Additional information, including more detailed appendices may be included, as
       appropriate. The instructions throughout the document indicate where additional information may be
       warranted depending on site complexity.

    •   Please refer to the EPA Communications Stylebook, EPA Correspondence manual, or other EPA style
       guide (as appropriate) as you are writing this five-year review for information on grammar, punctuation,
       spelling, vocabulary, syntax, usage and more.

    •   Text that is highlighted yellow and italicized in this recommended template provides general instructions
       for the user to follow when filling out that particular section. This highlighted text (and box that contains
       the highlighted text if applicable) should also be deleted after following the instructions and should not
       be included in the final FYR report.
OLEM 9200.0-89

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       Text that is highlighted blue in this recommended template should be replaced directly with the relevant
       site-specific information provided (e.g., name of local newspaper asks the FYR author to insert the name
       of the local newspaper for the town/county in which the site is located).

       Normal text (i.e. not highlighted or italicized) generally should be retained as language that is typically
       appropriate for the FYR report.

       For fields that look like this, Click here to enter a date., please select a date by clicking the field and then
       clicking the down arrow to open up a calendar.

       For fields that look like this, Choose an item., select an item from the drop down list.
           o  Note: The information included in the drop-down menus matches information that is used in the FYR
              module in SEMS; this drop-down menu is meant to ease data entry and help ensure consistency.

       Please refer to & consider EPA's existing Five-Year Review Guidance, as well as specific supplemental
       guidance as listed below:
           o  "Comprehensive Five-Year Review Guidance" (June 2001)
           o  "Assessing Protectiveness at Sites for Vapor Intrusion: Supplement to the 'Comprehensive Five-
              Year Review Guidance'" (November 2012)
           o  "Clarifying the Use of Protectiveness Determinations for CERCLA Five-Year Reviews"
              (September 2012)
           o  "Recommended Evaluation of Institutional Controls: Supplement to the 'Comprehensive Five-
              Year Review Guidance'" (September 2011)
           o  "Assessing Protectiveness for Asbestos Sites:  Supplemental Guidance to the Comprehensive
              Five-Year Review Guidance" (December 2009)
           o  "Five-Year Reviews, Frequently Asked Questions (FAQs) and Answers" (September 2009)
           o  "Five-Year Review Addendum Sample" (December 2008)
OLEM 9200.0-89

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[Page intentionally left blank.]

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  [INSERT NUMBER OF FYR "FIRST" "SECOND" "ETC..."] FIVE-YEAR REVIEW REPORT FOR
                            [SITE NAME] SUPERFUND SITE
                             [SITE COUNTY], [SITE STATE]
                                     Prepared by

                           U.S. Environmental Protection Agency
                               Region [INSERT REGION #]
                           [REGION CITY], [REGION STATE]
First and Last Name, Division Director                             Date

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The following Table of Contents shows typical major divisions and subheadings for Five-Year Review reports.
Subheadings may be included as needed.
   •  Note: If you choose to work from this document & keep the headings the same, the table of contents &
      page numbers have already been formatted. As a result, you may simply  click on the Table of Contents &
      then click "Update Table" to update the page numbers in the Table of Contents for your FYR.
   •  If you decide to include optional appendices, please make sure to incorporate them in this Table of
      Contents as well.
Table of Contents
LIST OF ABBREVIATIONS & ACRONYMS	2
I. INTRODUCTION	3
  SAMPLE FIVE-YEAR REVIEW SUMMARY FORM	4
II. RESPONSE ACTION SUMMARY	4
  Basis for Taking Action	4
  Response Actions	5
  Status of Implementation	5
  1C Summary Table	5
  Systems Operations/Operation & Maintenance	6
III. PROGRESS SINCE THE LAST RE VIEW	6
IV. FIVE-YEAR RE VIEW PROCESS	7
  Community Notification, Involvement & Site Interviews	7
  Data Review	7
  Site Inspection	8
V. TECHNICAL ASSESSMENT	8
  QUESTION A: Is the remedy functioning as intended by the decision documents?	8
  QUESTION B: Are the exposure assumptions,  toxicity data, cleanup levels, and remedial action
  objectives (RAOs) used at the time of the remedy selection still valid?	9
  QUESTION C: Has any  other information come to light that could call into question the
  protectiveness of the remedy?	10
VI. ISSUES/RECOMMENDATIONS	10
  OTHER FINDINGS	11
VII. PROTECTIVNESS STATEMENT	11
VIII. NEXT REVIEW	12
APPENDIX A - REFERENCE LIST	13

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LIST OF ABBREVIATIONS & ACRONYMS

For readability, this list normally should include only the most important abbreviations & acronyms that are
addressed in this five-year review.

ARAR        Applicable or Relevant and Appropriate Requirement
CERCLA      Comprehensive Environmental Response, Compensation, and Liability Act
CFR          Code of Federal Regulations
EPA          United States Environmental Protection Agency
FYR          Five-Year Review
ICs           Institutional Controls
NCP          National Oil and Hazardous Substances Pollution Contingency Plan
NPL          National Priorities List
O&M         Operation and Maintenance
PRP          Potentially Responsible Party
RAO          Remedial Action Objectives
ROD          Record of Decision
RPM          Remedial Project Manager
TBC          To be considereds
Insert any other acronyms/abbreviations used in the document

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I. INTRODUCTION
This recommended template does not include an executive summary because an introduction in a complete,
concise five-year review typically should provide a complete overview of the site. However, for more complex
sites with multiple operable units (OUs), it may be appropriate to include an executive summary.

The purpose of a Five-Year Review (FYR) is to evaluate the implementation and performance of a remedy in
order to determine if the remedy is and will continue to be protective of human health and the environment. The
methods, findings, and conclusions of reviews are documented in five-year review reports such as this one. In
addition, FYR reports identify issues found during the review, if any, and document recommendations to address
them.

The U.S. Environmental Protection Agency (EPA) is preparing this five-year review pursuant to the
Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Section 121, consistent
with the National Contingency Plan (NCP)(40 CFR Section 300.430(f)(4)(ii)), and considering EPA policy.

This is the number FYR for the Site name Superfund Site. The triggering action for this statutory or policy or
discretionary or list the type of review by OU if different triggering actions apply review is the on-site
construction start date of the OU # remedial action OR signature date of the Preliminary Close-Out Report OR
completion date of the previous FYR OR other. The FYR has been prepared due to the fact that hazardous
substances, pollutants, or contaminants remain at the site above  levels that allow for unlimited use and
unrestricted exposure (UU/UE).

If there are more than five (5) OUs that will be covered in this FYR, consider using a table to list them.
The Site consists of # of all OUs at the site, and # of OUs reviewed in this FYR will be addressed in this FYR.
OUX addresses what OUX addresses (e.g. "the groundwater remedy"). List what other OUs address in this FYR,
if applicable. [Include the following sentence if there are OUs not addressed in this FYR.] The X OUs that are not
addressed in this FYR are list OUs and reasons that these OUs are not included in this FYR (such as "XOU
doesn 't have a ROD").

The Site name Superfund Site Five-Year Review was led by lead author & affiliation. Participants included list all
participant affiliations & areas of expertise and/or names (as appropriate) such as the hydrologist, community
involvement coordinator, state agency representative, contract/IA support, etc... Include the following sentence for
enforcement lead sites:  [The relevant entities such as the PRP were/was notified of the  initiation of the five-year
review.] The review began on |

Site Background
    •  Normally, 2 paragraphs of background information about the site should provide an adequate description
       for most sites
           o   This information may be taken directly from decision documents
    •  Below is a list of suggested background topics to include:
           o   Location of site (i. e. populated or unpopulated areas) and brief physical description
           o   Former, current, and reasonably anticipated future land use of site and of areas surrounding the
               site (including historical practices resulting in contamination)
    •  If more background information is appropriate,  either include an optional appendix with more detailed
        information, reference a document (and include the document in Appendix A - Reference List) and/or list
       a website in this section where that information  is available.
           o   Note:  Website links can change, sometimes resulting in a broken link. As a result, if a website is
               listed also try to provide a document title that cites background information & reference this
               document in Appendix A - Reference List.

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                      SAMPLE FIVE-YEAR REVIEW SUMMARY FORM
Note: The "Review period" referenced below is meant to correspond to the start and end dates associated with
the preparation of this FYR report.
                                     SITE IDENTIFICATION
     Site Name:
     EPA ID:
     Region: Choose a
     Region #
State: Enter state
abbreviation
City/County: Enter City/County
     NPL Status: Choose an item
     Multiple OUs?
     Choose an item
         Has the site achieved construction completion?
         Choose an item
     Lead agency: Choose an item
     [If "Other Federal Agency", enter Agency name]:
     Author name (Federal or State Project Manager):
     Author affiliation:
     Review period: Click here to enter a date - Click here to enter a date
     Date of site inspection: Click here to enter a date
     Type of review: Choose an item
     Review number: Choose an item
     Triggering action date: Click here to enter a date
     Due date (fiveyears after triggering action date): Click here to enter a date
II. RESPONSE ACTION SUMMARY

This recommended template includes headings for the Response Action Summary section, however a narrative
format for this section (without headings) can also be used.
Basis for Taking Action
    •  List out the contaminants and/or contaminants of concern (COCs) by media type.
    •  Discuss resources/receptors that have been or could potentially be affected, as well as primary human
       and/or ecological health threat and exposure pathways.

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Response Actions
    •  Briefly summarize pre-ROD activities such as CERCLA removal actions, non-CERCLA
       removals/responses, and any related documents (such as enforcement orders or agreements) and parties
       involved in these activities; check with the enforcement program to ensure appropriate language.
    •  A bulleted list to briefly address the following items generally may be sufficient. You are encouraged to
       pull this information directly from site decision documents to maintain consistency. The items included
       may be broken down by decision document or OUas appropriate:
           o   RAOsfor the remedy selected in the ROD or amended ROD1
           o   Remedy components selected in the ROD or amended ROD2
                   *    Include engineering controls, access controls, ICs, and required monitoring,  broken
                       down by each OU or decision document.
           o   Remedy components that have been  modified in an ESD3
                   *    Include engineering controls, access controls, ICs, and required monitoring,  broken
                       down by each OU or decision document.
           o   Include  a table of cleanup levels selected in the ROD or amended ROD.
Status of Implementation
    •  The following information can be presented either chronologically or by OU:
           o   Briefly discuss the status of any response action or remedial action including whether remedial
               actions are complete or ongoing.
           o   If ICs are part of the selected remedy consider including a subheading for ICs as well as using
               the table below to represent implementation status.
    •  A 'big picture' status of the implementation normally should be included (e.g.,  'A berm was installed to
       improve surface drainage on January 4, 2014').
    •  A step by step report of the implementation normally is not necessary (e.g., 'We installed monitoring well
       #1 on March 5, 2012').

1C Summary Table (Optional - Include iflCs have been selected in a ROD or amended ROD, or modified in an ESD4)
Table X: Summary of Planned and/or Implemented ICs
Media, engineered
controls, and areas that do
not support UU/UE based
on current conditions
Media (e.g., groundwater,
soils, sediments)

ICs
Needed
Choose
an item
ICs Called
for in the
Decision
Documents
Choose an
item
Impacted
Parcel(s)

Parcel # or
other
identifying
information
1C
Objective
Use restriction or
notice provided by the
1C (e.g. restrict
installation of ground
water wells and
ground water use).
Title of 1C
Instrument
Implemented and
Date (or planned)
Instrument title
(e.g. Declaration
of Restrictive
Covenants, June
2003)
1 Please refer to "A Guide to Preparing Super fund Proposed Plans, Records of Decision, and Other Remedy Selection
Decision Documents. " USEPA. July 1999.
2 Please refer to "A Guide to Preparing Super fund Proposed Plans, Records of Decision, and Other Remedy Selection
Decision Documents. " USEPA. July 1999.
3 Please refer to "A Guide to Preparing Super fund Proposed Plans, Records of Decision, and Other Remedy Selection
Decision Documents. " USEPA. July 1999.
4 Please refer to "A Guide to Preparing Super fund Proposed Plans, Records of Decision, and Other Remedy Selection
Decision Documents. " USEPA. July 1999. Also please refer to "Institutional Controls: A Guide to Planning, Implementing,
Maintaining, and Enforcing Institutional Controls at Contaminated Sites (PIME). " USEPA. December 2012; and
"Recommended Evaluation of Institutional Controls: Supplement to the  'Comprehensive Five-Year Review Guidance "'
USEPA (September 2011).

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Systems Operations/Operation & Maintenance (Optional - Include if Appropriate)
    •  This information may be presented either chronologically or by OU,  and should include:
           o  A brief description of any modifications to the O&Mplan requirements since the last FYR,
              including changes related to the party conducting the activities
           o  A summary of any completed or ongoing O&M activities since the last FYR
           o  Problems in the implementation of system operations/O&M,  if applicable
III. PROGRESS SINCE THE LAST REVIEW
    •  The EXACT protectiveness statement and issues/recommendations from the last FYR normally should be
       used by copying & pasting from the last FYR or going into SEMS

This section includes the protectiveness determinations and statements from the last five-year review as well as
the recommendations from the last five-year review and the current status of those recommendations.

Table X: Protectiveness Determinations/Statements from the 20xx FYR
ou#
1
2
Sitewide
Protectiveness
Determination
Choose an item
Choose an item
Choose an item
Protectiveness Statement



If there were no issues & recommendations in the last FYR, please state that here; in this case, the table below
should be deleted and not used in this report.

Table X: Status of Recommendations from the 20xx FYR
ou#


Issue


Recommendations


Current
Status
Choose an
item
Choose an
item
Current Implementation Status
Description*


Completion
Date (if
applicable)
Click here to
enter a date
Click here to
enter a date
*Iffurther explanation is needed than can be reasonably formatted in the above table, please write the current
implementation status below for the applicable recommendation.

Recommendation # (Optional - Include if Appropriate)
    •  Discuss the implementation status of the first recommendation listed in the "Status of Recommendations
       from the 20XXFYR" table above

Recommendation # (Optional - Include if Appropriate)
    •  Discuss the implementation status of the second recommendation listed in the "Status of
       Recommendations from the 20XXFYR" table above

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IV. FIVE-YEAR REVIEW PROCESS

Community Notification, Involvement & Site Interviews
    •   At the discretion of the RPM & CIC or other lead site contacts, the Community Involvement Plan (CIP)
        should be used to help tailor the need for and type of community involvement activities at a site for the
        FYR process, including notification and interviews
            o  Note for Interviews:  The Five-Year Review Guidance discusses potential involvement of
               interested parties in FYR interviews, which may include the site manager; site personnel;
               Federal, State, and Tribal regulatory authorities; local officials; community action groups or
               associations;  residents and businesses located near the site; and other pertinent organizations or
               individuals.

A public notice was made available by state how the public notice was made available (e.g. by a newspaper
posting, press release, flyers door-to-door, e-mail notifications, telephone calls, mailing notices to homes, etc...)
and the title of the published notice if applicable (e.g., local newspaper name, press release form, etc), on C
               ite, stating that there was a five-year review and inviting the public to submit any comments to
the U.S. EPA. The results of the review and the report will be made available at the Site information repository
located at name of repository, physical or electronic address of repository.
 The Text in this Box is Optional -
    •   If interviews were conducted- the following section may be included
    •   If interviews were not conducted - the following section may not need to be included. If it is not included,
        consider providing information as to why interviews were not conducted (the CIP may be used to support
        the decision to not conduct interviews).
    •   Reminder: Delete box when yellow highlighted text is deleted.

 During the FYR process, interviews were conducted to document any perceived problems or successes with the
 remedy that has been implemented to date. The results of these interviews are summarized below.

 Include a brief summary (roughly two paragraphs) of the interview results here. Please keep in mind the
following:
    •   Unless you have received permission from interviewees that it is OK to include their name and any other
        information in the five-year review, you should not include this information.
    •   Information that may be relevant to the protectiveness determination(s) generally includes:
            o  Successes/problems in the implementation of access andlCs
            o  Successes/problems with the construction of the remedy and/or O&M
            o  Unusual situations or problems at the site
Data Review
    •   All of the data collected and statistical analyses of these data normally should not be included
    •   The focus normally should be on the last five years of data (except where additional historical data may
        be needed to evaluate trends)
    •   It can be useful to separate data by media and sub-media (e.g., soil, groundwater, sediment, surface
        water, fish tissue, or soil gas/indoor air)
           o  For sites with multiple OUs, separation by OU may be considered as well.
    •   Normally, it is useful to include data relevant to remedy performance and progress towards meeting
        RAOs

                                                   1

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    •  Generally, sufficient data to answer the technical assessment questions should be included
    •  Normally it is useful to include a concise summary of:
           o  Relevant data trends over the last five years, noting actual levels (e.g., measurements in specific
              well locations for a ground water cleanup), to evaluate whether RAOs and associated cleanup
              levels established in the ROD are likely to be achieved and/or have been achieved
           o  Data relevant to support engineering performance, such as data related to assessing plume
              capture
           o  For ground water cleanup, a brief discussion of data related to the site-specific groundwater
              remedy completion strategy
    •  Tables, maps or graphs may be used to help explain the text or may be included in an Appendix
    •  If a document that includes data is referenced, a citation to the document should be included and the
       reader should be directed to Appendix A - Reference List.

Site Inspection
The inspection of the Site was conducted on j                    Ť.. In attendance were RPM name, Lead
agency, Support agency representative (if applicable) of the Support agency name, and any additional members
and their respective organizations. The purpose of the inspection was to assess the protectiveness of the remedy.

Briefly describe results of the site inspection, particularly if issues  impacting current and/or future protectiveness
were observed
V. TECHNICAL ASSESSMENT

QUESTION A: Is the remedy functioning as intended by the decision documents?

Question A Summary:
    •  Include a concise, overall summary response to Question A here. This answer should summarize
       information obtained in carrying out the five year review process.
    •  Information gathered using the factors addressed in the three subheadings below can help support the
       answer.
    •   The answer should be complete and concise; normally a 'yes' or 'no' answer is not appropriate.

       Remedial Action Performance (Optional - Include if Appropriate)
           •   Whether the remedial action continues to operate and Junction as designed
           •   Whether cleanup levels are being achieved  or are on a path to be achieved in a reasonable time
              frame
           •   Whether containment is effective, if applicable
           •   Whether opportunities exist to improve the performance and/or reduce costs of monitoring,
              sampling, and treatment systems

       System Operations/O&M (Optional - Include if Appropriate)
           •   Whether operating procedures, as implemented, are working in a manner that will continue to
              maintain the effectiveness of the remedy
           •   Whether frequent equipment breakdowns or changes indicate a potential issue affecting
              protectiveness
           •   Whether large variances in O&M costs could indicate a potential remedy problem

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       Implementation of Institutional Controls and Other Measures (Optional - Include if Appropriate)
           •   Whether ICs are in place and are proving to be effective in preventing exposure
           •   Whether access controls (e.g., fencing and warning signs) are in place and are proving to be
               effective in preventing exposure
           •   Whether other actions (e.g., removals) necessary to ensure that immediate threats have been
               addressed are complete

QUESTION B:  Are the exposure assumptions, toxicity data, cleanup levels, and remedial action
objectives (RAOs) used at the time of the remedy selection still valid?

Question B Summary:
    •   Include  a concise, overall summary response to Question B here. This answer should summarize
       information obtained in carrying out the five year review process.
    •   Information gathered using the factors addressed in the five subheadings below can help support the
       answer.
    •    The answer should be complete and concise; normally a 'yes' or 'no' answer is not appropriate.
    •   Summary tables may be added to this section as appropriate (e.g. to summarize ARAR information)

       Changes in Standards and TBCs (Optional - Include if Appropriate)
           •   Whether standards identified as ARARs, newly promulgated standards, and/or changes in TBCs
               could call into question the protectiveness of the remedy
           •   Include additional information about existing ARARs, newly promulgated standards, and/or
               changes in TBCs that do not affect protectiveness here as appropriate or include in an optional
               Appendix

       Changes in Toxicity and Other Contaminant Characteristics (Optional - Include if Appropriate)
           •   Whether toxicity factors for contaminants of concern at the site have changed in a way that could
               affect the protectiveness of the remedy
           •   Whether other contaminant characteristics have changed in a way that could affect the
              protectiveness of the remedy

       Changes in Risk Assessment Methods (Optional - Include if Appropriate)
           •   Whether EPA 's standardized risk assessment methodologies or guidance have changed in a way
               that could affect the protectiveness of the remedy

       Changes in Exposure Pathways (Optional - Include if Appropriate)
           •   Whether current or reasonably anticipated future land use on or near the site has changed or
               may change in the near future  (including redevelopment or changed resource use)
           •   Whether human health or ecological routes of exposure or receptors have been newly identified
               or changed in a way that could affect the protectiveness of the remedy
           •   Whether there are newly identified contaminants or contaminant sources  leading to a
              potential/actual pathway not previously addressed by the remedy
           •   Whether there are unanticipated toxic byproducts or daughter products of the remedy not
              previously addressed by the decision documents
           •   Whether physical site conditions or the understanding of these conditions have changed in a way
               that could affect the protectiveness of the remedy

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       Expected Progress Towards Meeting RAOs (Optional - Include if Appropriate)
           •   Whether the remedy is progressing as expected towards meeting RAOs
           •   Whether new site conditions (e.g., discovery of new contaminants) impact RAOs and remedy
              protectiveness

QUESTION C:  Has any other information come to light that could call into question the
protectiveness of the remedy?
           •   Important Note: To avoid unnecessary duplication and redundancies, the information included
              in Question C normally should be different from information which has already been covered in
              Questions A & B.
           •   This question normally covers whether there are impacts from natural disasters
           •   This question may address site changes or vulnerabilities that may be related to climate change
              impacts not apparent during remedy selection, remedy implementation or O&M (e.g., sea level
              rise, changes in precipitation, increasing risk of floods, changes in temperature, increasing
              intensity of hurricanes and increasing wildfires, melting permafrost in northern regions, etc.).
VI. ISSUES/RECOMMENDATIONS
                                      Issues/Recommendations
     OU(s) without Issues/Recommendations Identified in the Five-Year Review:

     List OU's with no issues/recommendations here, or state 'none'

    •  Normally, issues/recommendations should not be added into the table(s) below if they don't affect either
       current and/or future protectiveness. Items included in the table(s) will be tracked in SEMS.
    •  Items may be included in the 'OTHER FINDINGS' section below the table (see below) if you wish to
       discuss additional information in the report.
    •  To add additional issues/recommendations here, copy and paste the below table as many times as
       necessary to document other issues/recommendations identified in the FYR report.

     Issues and Recommendations Identified in the Five-Year Review:                              I
OU(s):
Affect Current
Protectiveness
Choose an item
Issue Category: Choose an item
Note: If 'other ' is chosen, please provide an explanation in this box.
Issue:
Recommendation:
Affect Future
Protectiveness
Choose an item
Party
Responsible
Choose an item
Oversight Party
Choose an item
Milestone Date
Click here to enter
a date
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OTHER FINDINGS
    •   If there are items that you wish to include in the FYR report but should not be tracked as formal issues
       and recommendations affecting current and/or future protectiveness, please utilize the text below.

In addition, the following are recommendations that were identified during the FYR and (may improve
performance of the remedy, reduce costs, improve management of O&M, accelerate site close out, conserve
energy, promote sustainability, etc.), but do not affect current and/or future protectiveness:

    •   List items
VII. PROTECTIVNESS STATEMENT
    •  Each individual OUprotectiveness determination and statement should be included here.
    •  Guidance on wording for the protectiveness statement can be found in the memo titled "Clarifying the
       Use of Protectiveness Determinations for Comprehensive Environmental Response, Compensation, and
       Liability Act Five-Year Reviews " (September 13, 2012)
    •  If you need to add more protectiveness determinations and statements for additional OUs, copy and paste
       the table below as many times as necessary to complete for each OU evaluated in the FYR report.
    •  Per the 2001 FYR Guidance (p. 4-14),  the planned addendum completion date field normally should be
       entered if there is a "deferred protectiveness" determination for at least one OU. Otherwise, it may be
       deleted.
     Operable Unit:
                                      Protectiveness Statement(s)
Protectiveness Determination:
Choose an item
Planned Addendum
Completion Date:
Click here to enter a date
     Protectiveness Statement:
       For sites that have achieved Construction Completion, a sitewide protectiveness determination and
       statement normally should be entered in the table below.
       If the site has not met the Construction Completion milestone, then generally the table below should be
       deleted.
       Per the 2001 FYR Guidance (p. 4-14), the planned addendum completion date field normally should be
       entered if there is a "deferred protectiveness " determination for at least one OU (or if the Region is
       planning to conduct a FYR addendum for some particular reason). Otherwise it may be deleted.
                                  Sitewide Protectiveness Statement
     Protectiveness Determination:
     Choose an item
                                          Planned Addendum
                                          Completion Date:
                                          Click here to enter a date
     Protectiveness Statement:
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VIII. NEXT REVIEW
    •   Generally one of the two options below should be included in the report (and the one that is not chosen
       should be deleted).

The next five-year review report for the Site name Superfund Site is required five years from the completion date
of this review.

                                                OR

No further five-year reviews are planned for the Site name Superfund Site because all site-impacted media have
reached UU/UE.
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                        APPENDIX A - REFERENCE LIST
•  All relevant documents which were reviewed for this FYR, such as O&M records and monitoring data,
   should be included here.
•  Relevant document location information, such as website addresses, should be included for referenced
   documents.
                                OTHER APPENDICES
   Other optional appendices may include information such as:
       o  Site Background
       o  Site Chronology
       o  Site Inspection Checklist
       o  Site Maps
       o  Photos (only include photos that help inform the remedy protectiveness evaluation, such as a
          photo of a breach in a retaining wall)
       o  Review ofARARs
       o  Additional data or statistical analyses
       o  Interview results/notes
              *  Note:  Unless you have received permission from interviewees that it is OK to include
                 their name and any other information in the five-year review, do not include this
                 information.
       o  Conceptual site model(s)
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