UST Forms and Lists

Forms

Registration of UST Facilities (PDF) Revised January 2019. See also:

UST Facility Upgrade Registration (PDF) (UST Facility Upgrade Registration, MS Word) Revised March 2014.
Variance Application for Facilities Located Over Sand and Gravel Aquifers (PDF)
Double-walled Tank Warranty Extension Registration (PDF)
Waste-Water Treatment Tank Registration (PDF) Revised March 2019

Notification of Temporarily Out-Of-Service Tank(s) (PDF) If you are taking your tank out-of-service, you must complete and submit this notification form to the Department.

Return to Service Request for Out-of-Service Tanks (PDF) If you are returning your tank to service, you must complete and submit this notification form to the Department.

Notice of Intent to Remove an Underground Oil Storage Facility (PDF)

Chapter 691 Summary Cover Sheet for Underground Oil Storage Facility Site Assessment (PDF)

Modified Site Assessment for Replacement of Flexible Primary Product Piping without Excavation (PDF)

Certification of Inerting or Purging of Removed Underground Gasoline Tank (PDF)

Change of Ownership (PDF) If you are a new owner of a UST facility, you must complete and submit this notification form to the Department within 10 days of the date of transfer.

Annual UST Inspection (PDF) Annual UST inspection results must be submitted on this form. Inspection Form Instructions (pdf)

Underground Piping Associated with AST Motor Fuel Tanks Annual Inspection Form (PDF) (Annual AST Inspection Form MS Excel) Revised November 2023

Sump Tightness Testing (PDF) (Sump Tightness Testing, MS Excel) - Use this form to document sump tightness testing for Triennial testing, double-walled tank warranty extensions (with the extension registration) and any other sump testing.

Weekly Facility Walk-Through Inspection Checklist (PDF)

Daily Inventory (PDF) Revised December 2016 - Use for only single-walled motor fuel UST facilities or double-walled manually monitored facilities. Instructions included. Daily Inventory Calculator (MS Excel) - This spreadsheet may be used to calculate monthly overages and shortages instead of using the "print and fill-in" PDF version.

Safe Suction Piping Validation (PDF)

Spill Log (PDF) Log sheet for spill less than 10 gallons that occur on concrete or pavement and are properly cleaned up.

GW Monitoring Well Log (PDF) Groundwater Monitoring Well Log - Used only for single-walled consumptive use heating oil tanks.

Alarm Console Log (PDF) Revised April 2012 - Used to manually record weekly checks of the facility’s alarm console.