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Underground Storage Tank Branch

2019 Regulatory Amendments & Forms Effective April 5, 2019

​2019 Regulatory Amendments

Effective April 5, 2019

2019 Forms
DownloadTypeFile Size
DWM 4220 - UST Annual Walkthrough Inspection.docxdocx59176
DWM 4220 - UST Annual Walkthrough Inspection.pdfpdf201998
DWM 4221 - UST Automatic Line Leak Detector Operational Test.docxdocx66429
DWM 4221 - UST Automatic Line Leak Detector Operational Test.pdfpdf240407
DWM 4222 - UST Containment Device Test.docxdocx49147
DWM 4222 - UST Containment Device Test.pdfpdf135784
DWM 4223 - UST Electronic Release Detection Equipment Test.docxdocx52625
DWM 4223 - UST Electronic Release Detection Equipment Test.pdfpdf147229
DWM 4224 - UST Facility Owner Address Correction.docxdocx46638
DWM 4224 - UST Facility Owner Address Correction.pdfpdf159767
DWM 4225 - UST Facility Registration.docxdocx76851
DWM 4225 - UST Facility Registration.pdfpdf256026
DWM 4226 - UST Galvanic Cathodic Protection Evaluation.docxdocx72238
DWM 4226 - UST Galvanic Cathodic Protection Evaluation.pdfpdf209413
DWM 4227 - UST Impressed Current Cathodic Protection Evaluation.docxdocx77671
DWM 4227 - UST Impressed Current Cathodic Protection Evaluation.pdfpdf258161
DWM 4228 - UST Integrity Assessment.docxdocx49981
DWM 4228 - UST Integrity Assessment.pdfpdf141938
DWM 4229 - UST Line Tightness Test.docxdocx52497
DWM 4229 - UST Line Tightness Test.pdfpdf148964
DWM 4230 - UST Monthly Walkthrough Inspection.docxdocx68567
DWM 4230 - UST Monthly Walkthrough Inspection.pdfpdf201906
DWM 4231 - UST Notice of Intent to Install Underground Storage Tank or Piping.docxdocx43538
DWM 4231 - UST Notice of Intent to Install Underground Storage Tank or Piping.pdfpdf145685
DWM 4232 - UST Overfill Prevention Device Test.docxdocx47773
DWM 4232 - UST Overfill Prevention Device Test.pdfpdf138742
DWM 4233 - UST Rectifier Operational Record for Impressed Current Cathodic Protection Systems.docxdocx48437
DWM 4233 - UST Rectifier Operational Record for Impressed Current Cathodic Protection Systems.pdfpdf124663
DWM 4234 - UST System Compatibility Verification.docxdocx62838
DWM 4234 - UST System Compatibility Verification.pdfpdf173656
DWM 4235 - UST Tank Tightness Test.docxdocx53095
DWM 4235 - UST Tank Tightness Test.pdfpdf143437
DWM 4236 - UST Visual Interstitial Log.docxdocx47163
DWM 4236 - UST Visual Interstitial Log.pdfpdf134955
DWM 4260 - UST Certification of Properly Cleaned USTs.docxdocx42522
DWM 4260 - UST Certification of Properly Cleaned USTs.pdfpdf116229
DWM 4261 - UST Classification Guide.docxdocx61169
DWM 4261 - UST Classification Guide.pdfpdf164184
DWM 4262 - UST Closure Assessment Report Checklist.docxdocx79831
DWM 4262 - UST Closure Assessment Report Checklist.pdfpdf204070
DWM 4263 - UST Corrective Action Certification.docxdocx48667
DWM 4263 - UST Corrective Action Certification.pdfpdf120753
DWM 4264 - UST Groundwater Monitoring Checklist.docxdocx56061
DWM 4264 - UST Groundwater Monitoring Checklist.pdfpdf152985
DWM 4265 - UST Interim Corrective Action Checklist.docxdocx58053
DWM 4265 - UST Interim Corrective Action Checklist.pdfpdf157056
DWM 4266 - UST Notice of Intent to Permanently Close Underground Storage Tank or Piping.docxdocx44668
DWM 4266 - UST Notice of Intent to Permanently Close Underground Storage Tank or Piping.pdfpdf126818
DWM 4267 - UST Over-Excavation Checklist.docxdocx57966
DWM 4267 - UST Over-Excavation Checklist.pdfpdf156973
DWM 4268 - UST Site Check Checklist.docxdocx58597
DWM 4268 - UST Site Check Checklist.pdfpdf161379
DWM 4269 - UST Site Investigation Checklist.docxdocx61955
DWM 4269 - UST Site Investigation Checklist.pdfpdf166897
DWM 4270 - UST Vapor Intrusion Assessment Checklist.docxdocx63520
DWM 4270 - UST Vapor Intrusion Assessment Checklist.pdfpdf192539
DWM 4271 - UST Vapor Intrusion Building Assessment Checklist.docxdocx62151
DWM 4271 - UST Vapor Intrusion Building Assessment Checklist.pdfpdf172511
DWM 4280 - UST Affidavit of Termination of PSTEAF Contract.docxdocx51831
DWM 4280 - UST Affidavit of Termination of PSTEAF Contract.pdfpdf139291
DWM 4281 - UST Affidavit of Waiver for PSTEAF Reimbursement.docxdocx47490
DWM 4281 - UST Affidavit of Waiver for PSTEAF Reimbursement.pdfpdf120486
DWM 4282 - UST Application for Assistance for PSTEAF.docxdocx63356
DWM 4282 - UST Application for Assistance for PSTEAF.pdfpdf213642
DWM 4284 - UST Application for PSTEAF Eligible Companies or Partnerships.docxdocx65117
DWM 4284 - UST Application for PSTEAF Eligible Companies or Partnerships.pdfpdf187989
DWM 4285 - UST Claim Request for Actions Not Directed.docxdocx53350
DWM 4285 - UST Claim Request for Actions Not Directed.pdfpdf153382
DWM 4286 - UST Claim Request for Directed Actions.pdfpdf150750
DWM 4286 - UST Claim Request for Directed Actions.xlsxxlsx73862
DWM 4289 - UST Payment Waiver.docxdocx54361
DWM 4289 - UST Payment Waiver.pdfpdf153867
DWM 4290 - UST Reconsideration Request.docxdocx46518
DWM 4290 - UST Reconsideration Request.pdfpdf139753
DWM 4292 - UST Third-Party Claim.docxdocx51394
DWM 4292 - UST Third-Party Claim.pdfpdf179017
DWM 4293 - UST Application for Assistance for SOTRA.docxdocx56271
DWM 4293 - UST Application for Assistance for SOTRA.pdfpdf189396
2019 Manuals
DownloadTypeFile Size
42-060 UST Corrective Action Manual.pdfpdf1696730
42-020 UST System Compliance Manual.pdfpdf626848
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