UST FORMS
Corrective Action
|
Revision
Date |
PDF |
Doc |
|
| 20 Day Report | 8/2008 |
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||
| UST Clean Closure | 8/2008 |
|
||
| GCL
Table |
1/2010 |
 |
||
| Initial Abatement | 7/2001 |
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| MSCC
Table |
1/2010 | |
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| Site Check Report | 8/2008 |
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| UST-61 | 24-Hour
Release
and UST Leak Reporting Form |
2/2008 |
|
|
| Soil Permitting | ||||
| UST-70 |
Non-Discharge
Permit Application for Soil Remediation Projects |
1/2010 |
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|
| UST-71 | Certificate
of Approval for Storage/Treatment of Soil Containing Petroleum Products |
9/2003 |
|
|
| UST-72 | Agreement
for Land Application or Containment and Treatment of Soils Containing
Petroleum Products on Private Lands |
9/2003 |
|
|
Permits and Inspections |
|
|
|
|
| UST-2 | Site Investigation Report for Permanent Closure or Change-In-Service | 11/2006 | |
|
| UST-3 | Notice of Intent: UST Permanent Closure or Change-In-Service | 10/2006 | |
|
| UST-4 | Notice of Intent to Install Vapor or Groundwater Monitoring System | 2/2001 | |
|
| UST-5 | Site Investgation Report for Installation of Vapor or Groundwater Montoring System | 2/2001 | |
|
| UST-6A/B | Notice
of
Intent to Install USTs |
12/2008 | |
|
| UST-7A | Cathodic
Protection Testing form for galvanic cathodic protection systems |
9/2008 |
|
|
| UST-7B | Cathodic Protection Testing form for impresses current cathodic protection systems | 9/2008 | |
|
| UST-8 | Notification for Activities Involving Underground Storage Tanks | 2/2008 |
|
|
| UST-10A | UST Installation Inspection Checklist | 12/2009 | |
|
| UST-10B | UST
General
Requirements Inspection Checklist |
9/2009 |
|
|
| UST-12 | Closure Report Format | 11/2000 |
|
|
| UST-13 | Compartment Tank Notfication | 2/2001 |
|
|
| UST-15 | Change of Ownership of UST System(s) | 11/2000 |
|
|
| UST-15A | Ownership
of
UST Systems |
2/2002 |
|
|
| UST-16 | Manual Tank Gauging Record | 3/2004 |
|
|
| UST-17A | UST Suspected Release 24 Hour Notice Form | 11/2006 |
|
|
| UST-17B | UST Suspected Release 7 Day Notice Form | 10/2006 |
|
|
| UST-18 | Application for Tax Certification | 5/2004 |
|
|
| UST-19 | Certification of Leak Detection Exempt for Suction Piping Associated with USTs | 8/2005 |
|
|
| UST-20 | Alternative Fuel Compatability Checklist | 3/2007 |
|
|
| UST-21 | Impressesd Current Cathodic Protection System 60-Day Record of Rectifier Operation | 9/2008 |
|
|
| UST-22A |
Annual Overfill
Prevention Equipment Operability Check |
3/2010 |
|
|
| UST-22B |
Annual
Interstitial Sensor Operability Check |
3/2010 |
|
|
| UST-22C |
Annual
Containment Sump Visual Inspections |
3/2010 |
|
|
| UST-23A | Triennial
UST Spill Bucket Integrity Testing |
3/2010 | |
|
| UST-23B | Triennial UST Containment Sump/UDC Integrity Testing | 3/2010 | |
|
| UST-23C | Triennial UST Piping Integrity Testing | 3/2010 | |
|
| UST-23D |
Triennial UST Interstice Integrity Testing | 3/2010 |
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|
State Trust Funds |
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| Eligibility Forms | ||||
| Changes effective 3/1/08 Memo | 3/2008 |
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||
| Memo Eligibility Application Form | 1/2009 |
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| Eligibility
Application Form |
1/2009 |
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| Extra Tank Data Worksheet | 2/2008 |
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| Extra Corrosion Protection & Spill Overflow worksheet | 2/2008 |
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Reasonable Rate Documents |
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| 98 & 03 Reasonable Rates | ||||
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|
Financial Responsibility |
|||
| Chief Financial Officer Letter | 11/2005 |
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||
| Certificate
of
Insurance (UST-FR1) |
5/2006 |
|
|
|
| Certification of Financial Responsibility | 3/2009 |
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Federal Trust Funds |
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| Financial Data Request Form | 1/2004 |
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North Carolina Division of Waste Management
1646 Mail Service Center, Raleigh, NC 27699-1646
(919)508-8400
1646 Mail Service Center, Raleigh, NC 27699-1646
(919)508-8400
