Forms: Division of Environmental Response and Remediation

Division Forms

CERCLA Forms

Underground Storage Tank Forms

Cathodic Protection System Evaluation Forms

  • Galvanic (Sacrificial Anode) Cathodic Protection: PDF (45 KB) | DOC (128 KB)
  • Impressed Current Cathodic Protection: PDF (47 KB) | DOC (128 KB)

Certificate of Compliance Instructions and Forms

  • Certificate of Compliance Application Form: PDF (27 KB) | DOC (24 KB)
    (07/2013)
  • Certificate of Compliance Packet
  • Previous Pollution Incidents Form: PDF (12 KB) | DOC (21 KB)
    (09/2017)

Certification Applications

All applications submitted must be accompanied by the documentation and fees outlined by the eligibility requirements for certification.

Closure Forms

  • Temporary Closure: PDF (58 KB) | DOC (76 LB)
    (12/2005)—Must be filed if a tank is out of use for over three months.
  • Closure Plan Requirements
    Instructions for a permanent closure of an underground storage tank.
  • Closure Plan: PDF (100 KB) | DOC (235 KB)
    (07/2013)—For permanent closure of an underground storage tank.
  • Closure Notice: PDF (96 KB) | DOC (204 KB)
    (02/01/2015)—Must be filed within three months or 90 days of permanent tank closure.

Installation Forms

Underground Storage Tank Installation Notification Form (82 KB)
(8/1/2016)—For all new UST installations (fee required) as well as upgrades and repairs to existing UST systems (no fee required). Submit this form with any applicable fee at least 10 days prior to performing the work.

Comments and Questions

All questions and comments may be directed to David Wilson.