Various UST Program Forms

Underground Storage Tank (UST) Program

Forms

Leak Prevention

  • Monitoring System Certification - UST Monitoring Site Plan  »»  PDF  |  Word (Expires 9/31/2018)
  • Monitoring System Certification Form     PDF  |  Word - Fill-in " Print " Save (Expires 9/31/2018)
  • Request for Reconsideration   »»   PDF
  • Secondary Containment Testing Report Form  »»  PDF  |  Word (Expires 9/31/2018)
  • Spill Bucket Test Report Form  »»  Word (Expires 9/31/2018)
  • Vacuum/Pressure Sensor Certification Form  »»  Word (Expires 9/31/2018)

Leak Prevention (Effective October 1, 2018)

  • Monitoring System Certification Form »» PDF | Word (DRAFT)
  • Secondary Containment Testing Report Form »» PDF | Word (DRAFT)
  • Spill Container Test Report Form »» PDF | Word (DRAFT)
  • Overfill Prevention Equipment Inspection Report Form »» PDF | Word (DRAFT)
  • Statement of Understanding and Compliance »» PDF | Word (DRAFT)
  • Designated Underground Storage Tank Operator Identification Form »» PDF | Word (DRAFT)
  • Facility Employee Certificate »» PDF | Word (DRAFT)
  • Designated Underground Storage Tank Operator Visual Inspection Report »» PDF | Word (DRAFT)

Leak Reporting

  • Unauthorized Release Form  »»  PDF  |  Word – Fill-in » Print » Save
  • Regulators: To report Unauthorized Release go to GeoTracker's CREATE NEW PROJECT online

UST Compliance Reporting

  • Report 6
    • Semi-annual Underground Storage Tank (UST) Program Report Form  »»  Word
    • Instructions for Completing Report 6, Semi-annual UST Program Report  »»  PDF
  • Financial Responsibility Website
    • Certification of Financial Responsibility Form  »»  PDF

UST Facilities

NOTE: Forms A, B, C and D. are no longer valid. The information contained on those forms is now required to be entered into the California Electronic Reporting System (CERS).

  • Form A - Facility Permitting  »»  PDF  |  Word – Fill-in » Print » Save
  • Form B - UST Permitting  »»  PDF  |  Word – Fill-in » Print » Save
  • Form C - Certificate of Compliance  »»  PDF
  • Form D - Monitoring Plan  »»  PDF  |  Word – Fill-in » Print » Save
  • Form E - Response Plan  »»  PDF  |  Word – Fill-in » Print » Save

Tank Testers

  • New Licenses
    • Application for Tank Tester License  »»  PDF
    • Certificate in Support Experience  »»  PDF
  • License Renewal  »»  PDF
  • License Re-Instatement  »»  PDF