Forms and Applications

Documents may be uploaded through the DEP Public Upload with Payment(opens in a new tab) system. Instructions(opens in a new tab) (PDF)
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AST Applications and Forms

• Aboveground Storage Tank Inspection Summary(opens in a new tab) (2630-FM-BECB0150) is comprised of instructions and fill-in-form in both Word and PDF format.
• Aboveground Storage Tank Modification Inspection Summary(opens in a new tab) (2630-FM-BECB0601) is comprised of instructions and fill-in-form in both Word and PDF format.
• Aboveground Storage Tank Lining Inspection Summary(opens in a new tab) (2630-FM-BECB0014) (Word and PDF)
• Sample Monthly Maintenance Operation Checklist (opens in a new tab)form (2630-FM-BECB0170) for owners of small aboveground storage tanks (ASTs). (Word and PDF)
• Aboveground Storage Tank Modification Report(opens in a new tab) (2630-FM-BECB0151) consists of instructions and fill-in-form in both Word and PDF format.
• Notification of Release - Notification of Contamination Form(opens in a new tab) (2630-FM-BECB0082) is available in Word and PDF formats.
• Storage Tank System Closure Report for aboveground tanks is comprised of the following documents:
  • Planning for Permanent Closure Checklist(opens in a new tab) (2630-FM-BECB0512) (Word and PDF)
  • Closure Notification(opens in a new tab) (2630-FM-BECB0513) (Word and PDF)
  • Aboveground Storage Tank System Closure Report Form(opens in a new tab) (2630-FM-BECB0514) (Word and PDF)
    
  • Site Assessment Sampling Requirements at Regulated Storage Tank System Closures(opens in a new tab) (PDF). This document contains the recommended containers for sampling, test parameters for soil and water samples, and action levels for confirmatory samples.
    

Certification Applications

• Company Certification Application(opens in a new tab) (2630-PM-BECB0510) Package is comprised of instructions and application. (Word and PDF)
• Installer and Inspector Certification Application package(opens in a new tab) (2630-PM-BECB0506) is comprised of instructions, application form, Attachment A instructions, Attachment A (Total Experience and Qualification), Certified Installer & Inspector Categories Minimum Experience and Education Qualifications, and Amendment documents. (Word and PDF)
  • Installer and Inspector Certification Amendment (2630-PM-BECB0506a) (Word(opens in a new tab) and PDF(opens in a new tab)) is required to be submitted within 14 days of a change in the information provided in the individual's certification application. This includes employment, address, and phone number changes.
• Storage Tank Training Course Approval Application form(opens in a new tab) (2630-PM-BECB0402) consists of instructions and application form. (Word and PDF)

Permitting Applications

• General Information Form (GIF)(opens in a new tab) (4700-PM-CEE0001): Consists of instructions, check list, GIF form, NAICS codes, locational data codes, and an Appendix for Authorization/Applications types affected by Land Use Policy.
• Registration/Permitting of Storage Tanks package(opens in a new tab) (2630-PM-BECB0514) is comprised of instructions, registration (Adobe and Word fill-in-form formats), client types codes, location data codes, North American Industry Classification Codes (NAICS) and Site-to-Client relationship codes. (Word and PDF) Visit our ePermitting page for information on registration submittal through the DEP ePermitting application.
• Registration Amendment Form(opens in a new tab) (2630-FM-BECB0607) is comprised of instructions and fill-in-form in Word or PDF format. Visit our ePermitting page for information on registration submittal through the DEP ePermitting application.
• Site Specific Installation Permit(opens in a new tab) (2630-PM-BECB0002) package is comprised of the application, instructions, and completeness review checklist. (Word and PDF)

Registration Applications

• Registration/Permitting of Storage Tanks package(opens in a new tab) (2630-PM-BECB0514) is comprised of instructions, registration (Adobe and Word fill-in-form formats), client types codes, location data codes, North American Industry Classification Codes (NAICS) and Site-to-Client relationship codes. (Word and PDF) Visit our ePermitting page for information on registration submittal through the DEP ePermitting application.
• Registration Amendment Form(opens in a new tab) (2630-FM-BECB0607) is comprised of instructions and fill-in-form in Word or PDF format.

The Underground Storage Tank Operator Training Documentation Form(opens in a new tab) (2630-PM-BECB0514a) (Word and PDF), along with copies of the Class A and B Operators' training certificates, are required to be submitted with Storage Tank Registration/Permitting Application Forms in the following situations:

• Change of Ownership of a UST facility
• Changing the status of a UST from "T" - Temporarily Out of Use to "C" - Currently in Use
• Adding a UST to an existing facility
• Registering a new UST facility

Installation of a new storage tank system, or conversion of an existing storage tank system, to store alternative fuels or fuel blends may require submittal of the Alternative Fuel Storage Tank Installation/Conversion Form(opens in a new tab). This form is used to ensure compatibility of tank system components with gasoline blends containing greater than 10 percent alternative fuel and biodiesel blended fuels containing greater than 5 percent biodiesel.

Underground storage tank installers requiring product delivery, in order to provide ballast or when needed for testing purposes, may use the New Installation Product Fill Authorization form(opens in a new tab). Please read the form carefully.

UST Applications and Forms

• Pollution Prevention Reimbursement Grant Package(opens in a new tab) (aka "Pump & Plug Program") application (2630-FM-BECB0370) (Word and PDF). Please note the IRS W-9 form may not be the latest edition. The following links to the IRS W-9(opens in a new tab) (PDF) and its instructions(opens in a new tab) (PDF) have been provided for your convenience.
• Underground Storage Tank Modification Report(opens in a new tab) (2630-FM-BECB0575) (Word and PDF). Instructions are also available.
• Notification of Release - Notification of Contamination Form(opens in a new tab) (2630-FM-BECB0082) (PDF and Word)
• Storage Tank System Closure Report for underground tanks is comprised by the following documents:
  • Planning for Permanent Closure Checklist(opens in a new tab) (2630-FM-BECB0126) (Word and PDF). Checklist for planning permanent closure.
  • Notification of Release - Notification of Contamination Form(opens in a new tab) (2630-FM-BECB0082) (Word and PDF). Notification form for releases and suspected or confirmed contamination.
  • Underground Storage Tank System Installation/Closure Notification Form(opens in a new tab) (2630-FM-BECB0127) (Word and PDF). This form must be received by the DEP regional office at least 30 days prior to starting applicable tank handling, installation, or closure activities.
  • Underground Storage Tank System Closure Report Form(opens in a new tab) (2630-FM-BECB0159) (Word and PDF)
    
  • Site Assessment Sampling Requirements at Regulated Storage Tank System Closures(opens in a new tab) (PDF). This document contains the recommended containers for sampling, test parameters for soil and water samples, and action levels for confirmatory samples.
    
• UST Facility Inspection forms
  • Facility Operations Inspection Form(opens in a new tab) (2630-FM-BECB0501a) (Word and PDF)
  • Storage Tank Facility Site Drawing(opens in a new tab) (2630-FM-BECB0027) (Word and PDF)
  • UST Cathodic Protection Evaluation Form(opens in a new tab) (2630-FM-BECB0610) (Word and PDF)
• UST Periodic Testing forms
  • Underground Storage Tank Testing Certification Form(opens in a new tab) (2630-FM-BECB0028) (Word and PDF)
  • Underground Storage Tank Spill Prevention Equipment/Containment Sump Integrity Testing Form(opens in a new tab) (2630-FM-BECB0016) (Word and PDF)
  • Underground Storage Tank Automatic Tank Gauge Functionality Testing Form(opens in a new tab) (2630-FM-BECB0015) (Word and PDF)
  • Underground Storage Tank Sensor Functionality Testing Form(opens in a new tab) (2630-FM-BECB0020) (Word and PDF)
  • Underground Storage Tank Overfill Prevention Evaluation Form(opens in a new tab) (2630-FM-BECB0018) (Word and PDF)
  • Underground Storage Tank Automatic Line Leak Detector Functionality Testing Form(opens in a new tab) (2630-FM-BECB0021) (Word and PDF)
  • Underground Storage Tank Pressure/Vacuum Monitoring Functionality Testing Form(opens in a new tab) (2630-FM-BECB0017) (Word and PDF)
  • Underground Storage Tank Groundwater/Vapor Monitoring System Functionality Testing Form(opens in a new tab) (2630-FM-BECB0019) (Word and PDF)
• Sample Periodic Operation and Maintenance Walkthrough Inspection Checklist for USTs(opens in a new tab) (2630-FM-BECB0611) (Word and PDF)​