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Kentucky Energy and Environment Cabinet
Underground Storage Tank Branch

​2019 Regulatory Amendments

Effective April 5, 2019

2019 Forms
DownloadTypeFile Size
DWM 4220 - UST Annual Walkthrough Inspection.docxdocx56868
DWM 4220 - UST Annual Walkthrough Inspection.pdfpdf196464
DWM 4221 - UST Automatic Line Leak Detector Operational Test.docxdocx57663
DWM 4221 - UST Automatic Line Leak Detector Operational Test.pdfpdf218171
DWM 4222 - UST Containment Device Test.docxdocx44147
DWM 4222 - UST Containment Device Test.pdfpdf130265
DWM 4223 - UST Electronic Release Detection Equipment Test.docxdocx46473
DWM 4223 - UST Electronic Release Detection Equipment Test.pdfpdf141668
DWM 4224 - UST Facility Owner Address Correction.docxdocx42136
DWM 4224 - UST Facility Owner Address Correction.pdfpdf154226
DWM 4225 - UST Facility Registration.docxdocx74408
DWM 4225 - UST Facility Registration.pdfpdf250502
DWM 4226 - UST Galvanic Cathodic Protection Evaluation.docxdocx62129
DWM 4226 - UST Galvanic Cathodic Protection Evaluation.pdfpdf203832
DWM 4227 - UST Impressed Current Cathodic Protection Evaluation.docxdocx67887
DWM 4227 - UST Impressed Current Cathodic Protection Evaluation.pdfpdf252562
DWM 4228 - UST Integrity Assessment.docxdocx44793
DWM 4228 - UST Integrity Assessment.pdfpdf136426
DWM 4229 - UST Line Tightness Test.docxdocx46418
DWM 4229 - UST Line Tightness Test.pdfpdf143449
DWM 4230 - UST Monthly Walkthrough Inspection.docxdocx66233
DWM 4230 - UST Monthly Walkthrough Inspection.pdfpdf196359
DWM 4231 - UST Notice of Intent to Install Underground Storage Tank or Piping.docxdocx41105
DWM 4231 - UST Notice of Intent to Install Underground Storage Tank or Piping.pdfpdf140160
DWM 4232 - UST Overfill Prevention Device Test.docxdocx42936
DWM 4232 - UST Overfill Prevention Device Test.pdfpdf133206
DWM 4233 - UST Rectifier Operational Record for Impressed Current Cathodic Protection Systems.docxdocx43316
DWM 4233 - UST Rectifier Operational Record for Impressed Current Cathodic Protection Systems.pdfpdf119133
DWM 4234 - UST System Compatibility Verification.docxdocx54592
DWM 4234 - UST System Compatibility Verification.pdfpdf168106
DWM 4235 - UST Tank Tightness Test.docxdocx47584
DWM 4235 - UST Tank Tightness Test.pdfpdf137923
DWM 4236 - UST Visual Interstitial Log.docxdocx42218
DWM 4236 - UST Visual Interstitial Log.pdfpdf129434
DWM 4260 - UST Certification of Properly Cleaned USTs.docxdocx39935
DWM 4260 - UST Certification of Properly Cleaned USTs.pdfpdf110680
DWM 4261 - UST Classification Guide.docxdocx59451
DWM 4261 - UST Classification Guide.pdfpdf158667
DWM 4262 - UST Closure Assessment Report Checklist.docxdocx69683
DWM 4262 - UST Closure Assessment Report Checklist.pdfpdf198514
DWM 4263 - UST Corrective Action Certification.docxdocx46366
DWM 4263 - UST Corrective Action Certification.pdfpdf115214
DWM 4264 - UST Groundwater Monitoring Checklist.docxdocx50199
DWM 4264 - UST Groundwater Monitoring Checklist.pdfpdf147444
DWM 4265 - UST Interim Corrective Action Checklist.docxdocx52268
DWM 4265 - UST Interim Corrective Action Checklist.pdfpdf151509
DWM 4266 - UST Notice of Intent to Permanently Close Underground Storage Tank or Piping.docxdocx42176
DWM 4266 - UST Notice of Intent to Permanently Close Underground Storage Tank or Piping.pdfpdf121271
DWM 4267 - UST Over-Excavation Checklist.docxdocx52592
DWM 4267 - UST Over-Excavation Checklist.pdfpdf151444
DWM 4268 - UST Site Check Checklist.docxdocx57482
DWM 4268 - UST Site Check Checklist.pdfpdf155862
DWM 4269 - UST Site Investigation Checklist.docxdocx59911
DWM 4269 - UST Site Investigation Checklist.pdfpdf161364
DWM 4270 - UST Vapor Intrusion Assessment Checklist.docxdocx56466
DWM 4270 - UST Vapor Intrusion Assessment Checklist.pdfpdf186998
DWM 4271 - UST Vapor Intrusion Building Assessment Checklist.docxdocx55679
DWM 4271 - UST Vapor Intrusion Building Assessment Checklist.pdfpdf166944
DWM 4280 - UST Affidavit of Termination of PSTEAF Contract.docxdocx47964
DWM 4280 - UST Affidavit of Termination of PSTEAF Contract.pdfpdf133526
DWM 4281 - UST Affidavit of Waiver for PSTEAF Reimbursement.docxdocx44250
DWM 4281 - UST Affidavit of Waiver for PSTEAF Reimbursement.pdfpdf114925
DWM 4282 - UST Application for Assistance for PSTEAF.docxdocx56952
DWM 4282 - UST Application for Assistance for PSTEAF.pdfpdf208091
DWM 4284 - UST Application for PSTEAF Eligible Companies or Partnerships.docxdocx56625
DWM 4284 - UST Application for PSTEAF Eligible Companies or Partnerships.pdfpdf182389
DWM 4285 - UST Claim Request for Actions Not Directed.docxdocx51088
DWM 4285 - UST Claim Request for Actions Not Directed.pdfpdf147831
DWM 4286 - UST Claim Request for Directed Actions.pdfpdf118153
DWM 4286 - UST Claim Request for Directed Actions.xlsxxlsx75131
DWM 4289 - UST Payment Waiver.docxdocx49144
DWM 4289 - UST Payment Waiver.pdfpdf148362
DWM 4290 - UST Reconsideration Request.docxdocx42036
DWM 4290 - UST Reconsideration Request.pdfpdf132709
DWM 4292 - UST Third-Party Claim.docxdocx46744
DWM 4292 - UST Third-Party Claim.pdfpdf168201
DWM 4293 - UST Application for Assistance for SOTRA.docxdocx50398
DWM 4293 - UST Application for Assistance for SOTRA.pdfpdf183847
2019 Manuals
DownloadTypeFile Size
42-020 UST System Compliance Manual.pdfpdf379813
42-060 UST Corrective Action Manual.pdfpdf1320632
Kentucky Energy and Environment Cabinet
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Frankfort, KY 40601    

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