7530-1 Notification for Storage of Underground Tanks

Underground Storage Tanks: Technical and Financial Requirements, and State Program Approval Procedures (Renewal)

EPA Form 7530-1

Underground Storage Tanks - State, Local, or Tribal Governments

OMB: 2050-0068

Document [docx]

Download: docx | pdf

Appendix I to Part 280

U nited States

Environmental Protection Agency

Washington, DC 20460

Approval expires xx/xx/xx

OMB No.2050-0068

Notification for Underground Storage Tanks

Implementing Agency Name And Address:

IMPLEMENTING AGENCY USE ONLY

ID NUMBER:

DATE RECEIVED:

TYPE OF NOTIFICATION

DATE ENTERED INTO COMPUTER:

 A. NEW FACILITY OR ONE-TIME NOTIFICATION (previously deferred system)

 B. AMENDED

 C. CLOSURE OR CHANGE-IN-SERVICE

DATA ENTRY CLERK INITIALS:

OWNER WAS CONTACTED TO CLARIFY RESPONSES, COMMENTS:

_____ Number of tanks at facility

_____ Number of continuation sheets attached

What USTs Are Included? An UST system is defined as anyone or combination of tanks that is used to contain an accumulation of regulated substances, and whose volume (including connected underground piping) is 10 percent or more beneath the ground. Regulated USTs store petroleum or hazardous substances (see What Substances Are Covered below). This includes UST systems with field-constructed tanks and airport hydrant fuel distribution systems.

What Tanks Are Excluded From Notification (see § 280.10 and § 280.12)?

Tanks removed from the ground before May 8, 1986;
Farm or residential tanks of 1,100 gallons or less capacity storing motor fuel for noncommercial purposes;
Tanks storing heating oil for use on the premises where stored;
Septic tanks;
Certain pipeline facilities regulated under chapters 601 and 603 of Title 49;
Surface impoundments, pits, ponds, or lagoons;
Storm water or wastewater collection systems;
Flow-through process tanks;
Liquid traps or associated gathering lines directly related to oil or gas production and gathering operations;
Tanks on or above the floor of underground areas, such as basements or tunnels;
Tanks with a capacity of 110 gallons or less;
Wastewater treatment tank systems;
UST systems containing radioactive material that are regulated under the Atomic Energy Act of 1954;
UST systems that are part of an emergency generator system at nuclear power generation facilities regulated by the Nuclear Regulatory Commission under 10 CFR part 50.

What Substances Are Covered? The notification requirements apply to USTs containing petroleum or certain hazardous substances. Petroleum includes gasoline, used oil, diesel fuel, crude oil or any fraction thereof which is liquid at standard conditions of temperature and pressure (60 degrees Fahrenheit and 14.7 pounds per square inch absolute). Hazardous substances are those found in Section 101 (14) of the Comprehensive Environmental Response, Compensation and Liability Act of 1980, with the exception of those substances regulated as hazardous waste under Subtitle C of the Resource Conservation and Recovery Act.

When and Who to Notify? Owners who bring USTs into use after May 8, 1986 must submit this notification form to the implementing agency within 30 days of bringing the UST into use. If the implementing agency requires notification of any amendments to the facility, send information to the implementing agency immediately.

Penalties: Any owner who knowingly fails to notify or submits false information shall be subject to a civil penalty not to exceed $16,000 for each tank for which notification is not given or for which false information is given.

INSTRUCTIONS AND GENERAL INFORMATION

Please type or print in ink. Also, be sure you have signatures in ink for sections VIII and XI. Complete a notification form for each location containing underground storage tanks. If more than 5 tanks are owned at this location, you may photocopy pages 3 through 6 and use them for additional tanks.

The primary purpose of this notification form is to provide information about the installation, existence, changes to, and closure of underground storage tank systems (USTs) that store or have stored petroleum or hazardous substances. The information you provide will be based on reasonably available records, or in the absence of such records, your knowledge or recollection.

Federal law requires UST owners to use this notification form for all USTs storing regulated substances that are brought into use after May 8, 1986, or USTs in the ground as of May 8, 1986 that have stored regulated substances at any time since January 1, 1974. The information requested is required by Section 9002 of the Solid Waste Disposal Act (SWDA), as amended.

Who Must Notify? 40 CFR part 280, as amended, requires owners of USTs that store regulated substances (unless exempted) to notify implementing agencies of the existence of their USTs. Owner is defined as:

In the case of an UST in use on November 8, 1984, or brought into use after that date, any person who owns an UST used for storage, use, or dispensing of regulated substances; or
In the case of an UST in use before November 8, 1984, but no longer in use on that date, any person who owned the UST immediately before its discontinuation.

Also, owners of previously deferred UST systems with field-constructed tanks and airport hydrant fuel distribution systems in the ground as of May 8, 1986 must submit a one-time notification of existence by May 8, 1989. Owners of UST systems with field-constructed tanks and airport hydrant fuel distribution systems brought into use after May 8, 1986 are considered new facilities and must follow the same notification requirements as all other UST owners.

I. OWNERSHIP OF USTs

II. LOCATION OF USTs

Owner Name (Corporation, Individual, Public Agency, Or Other Entity)

If required by implementing agency, give the geographic location of USTs either in decimal degrees, or degrees, minutes, and seconds. Example: Latitude: 36.123480 (or 36 7' 24.4"), Longitude: -106.549876 (or -106 32' 59.6")

Latitude ________________ Longitude ________________

Street Address

County

Facility Name Or Company Site Identifier, As Applicable

 If address is the same as in Section I, check the box and proceed to section III.

If address is different, enter address below:

Street Address

County

City

State

Zip Code

Phone Number (Include Area Code)

City

State

Zip Code

U nited States

Environmental Protection Agency

Washington, DC 20460

Approval expires xx/xx/xx

OMB No.2050-0068

Notification For Underground Storage Tanks

III. TYPE OF OWNER

IV. INDIAN COUNTRY

 Federal

Government

 State

Government

 Commercial

 Tribal

Government

 Local

Government

 Private

USTs are located on land within an Indian reservation or on trust lands outside reservation boundaries



Federally recognized tribe where USTs are located:

V. TYPE OF FACILITY

 Auto Dealership

 Federal – Military

 Residential

 Commercial Airport Or Airline

 Gas Station

 Trucking Or Transport

 Contractor

 Industrial

 Utilities

 Farm

 Petroleum Distributor

 Other (Explain) ____________________

 Federal – Non-military

 Railroad

VI. CONTACT PERSON IN CHARGE OF TANKS

Name:

Job Title:

Address:

Phone Number (Include Area Code):

VII. FINANCIAL RESPONSIBILITY

 I have met the financial responsibility requirements (in accordance with 40 CFR part 280 Subpart H) by using the following mechanisms:

(check all that apply)

 Bond Rating Test

 Local Government Financial Test

 Surety Bond

 Commercial Insurance

 Risk Retention Group

 Trust Fund

 Guarantee

 Self-insurance (Financial Test)

 Other Method (describe here)

 Letter Of Credit

 State Fund

___________________________

 I do not have to meet financial responsibility requirements because 40 CFR part 280 Subpart H is not applicable to me (e.g., if you are a state or federal owner).

VIII. CERTIFICATION (Read and sign after completing ALL SECTIONS of this notification form)

I certify under penalty of law that I have personally examined and am familiar with the information submitted in Sections I through XI of this notification form and all attached documents, and that based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the submitted information is true, accurate, and complete.

Name and official title of owner or owner’s authorized representative (Print)

Signature

Date Signed

Paperwork Reduction Act Notice

The public reporting and recordkeeping burden for this collection of information is estimated to average 30 minutes per response. Responses to this collection of information are mandatory (40 CFR 280.22). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2050-0068).

Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

U nited States

Environmental Protection Agency

Washington, DC 20460

Approval expires xx/xx/xx

OMB No.2050-0068

Notification For Underground Storage Tanks

IX. DESCRIPTION OF UNDERGROUND STORAGE TANKS (Complete for all tanks and piping at this location)

Tank Identification Number

Tank No.

1. Status Of Tank (check only one)

Currently In Use

Temporarily Closed

Permanently Closed



2. Date Of Installation (month/year)

3. Estimated Total Capacity (gallons)

4. Tank Attributes
(check all that apply)

Asphalt Coated Or Bare Steel



Cathodically Protected Steel

(impressed current)



Cathodically Protected Steel

(sacrificial anodes)



Coated and Cathodically Protected Steel

(impressed current)



Coated and Cathodically Protected Steel

(sacrificial anodes)



Composite
(steel clad with noncorrodible material)



Concrete



Fiberglass Reinforced Plastic



Noncorrodible Tank Jacket



Lined Interior



Excavation Liner



Double Walled



Manifolded



Compartmentalized



Field-constructed



Double Walled



Unknown



Other, Specify Here

___________

Check Box If Tank Has Ever Been Repaired



5. Overfill Protection Installed

(check all that apply)

Automatic Shutoff



Flow Restrictor



High-level Alarm



Other, Specify Here

___________

6. Spill Prevention Installed



Double Walled



U nited States

Environmental Protection Agency

Washington, DC 20460

Approval expires xx/xx/xx

OMB No.2050-0068

Notification For Underground Storage Tanks

Tank Identification Number

Tank No.

7. Piping Attributes

(check all that apply)

Bare Steel



Galvanized Steel



Fiberglass Reinforced Plastic



Flexible Plastic



Copper



Cathodically Protected

(impressed current)



Cathodically Protected

(sacrificial anodes)



Double Walled



Secondary Containment



Airport Hydrant Piping



Unknown



Other, Specify Here

___________

8. Piping Delivery Type

(check all that apply)

Safe Suction (no valve at tank)



U.S. Suction (valve at tank)



Pressure



Gravity Feed



9. Substance Currently Stored (or last stored in the case of closed tanks) (check all that apply)

Gasoline (containing ≤ 10% ethanol)



Diesel



Biodiesel



Kerosene



Heating Oil



Used Oil



Gasoline Containing >10% Ethanol (specify amount of ethanol)

___________

Diesel Containing >20% Biodiesel

(specify amount of biodiesel)

___________

Other, specify here

___________

Hazardous Substance



CERCLA Name Or CAS Number

___________

Mixture Of Substances



Please Specify Substances Here

___________

U nited States

Environmental Protection Agency

Washington, DC 20460

Approval expires xx/xx/xx

OMB No.2050-0068

Notification For Underground Storage Tanks

Tank Identification Number

Tank No.

10. Release Detection

(check all that apply)

TANK

PIPE

TANK

PIPE

TANK

PIPE

TANK

PIPE

TANK

PIPE

Manual Tank Gauging



Tank Tightness Testing



Inventory Control



Automatic Tank Gauging



Vapor Monitoring



Groundwater Monitoring



Interstitial Monitoring
(required for new or replaced

tanks or piping)



Statistical Inventory Reconciliation



Automatic Line Leak Detectors



Line Tightness Testing



No Release Detection Required
(such as some types of suction piping)



Other Method Allowed By Implementing Agency



Other, Specify Here

___________

X. CLOSURE OR CHANGE IN SERVICE

1. Closure Or Change In Service

Estimated Date The UST Was Last Used For Storing Regulated Substances (month/day/year)

___________

Check Box If This Is A Change In Service

(i.e., Change of storage to a non-regulated substance)



2. Tank Closure

Estimated Date Tank Closed (month/day/year)

___________

(check all that apply below)

Tank Removed From Ground



Tank Closed In Ground



Tank Filled With Inert Material



Describe The Inert Fill Material Here

___________

3. Site Assessment

Check Box If The Site Assessment Was Completed



Check Box If Evidence Of A Release Was Detected



Other, Specify Here

___________

U nited States

Environmental Protection Agency

Washington, DC 20460

Approval expires xx/xx/xx

OMB No.2050-0068

Notification For Underground Storage Tanks

Tank Identification Number

Tank No.

XI. CERTIFICATION OF INSTALLATION (Complete for UST Systems Installed After December 22, 1988 and for Airport Hydrant Distribution Systems and Field-Constructed USTs Installed After May 8, 1986)

Installer Of Tank And Piping

(check all that apply)

Installer Certified By Tank And Piping Manufacturers



Installer Certified Or Licensed By The Implementing Agency



Installation Inspected By A Registered Engineer



Installation Inspected And Approved By Implementing Agency



Manufacturer’s Installation Checklists Have Been Completed



Another Method Allowed By Implementing Agency



Specify Other Method Here

___________

Signature Of UST Installer Certifying Proper Installation Of UST System

___________________________

Name

___________________________

Signature

_________________

Date

___________________________

Position

___________________________

Company

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Cho Yi Kwan
File Modified	0000-00-00
File Created	2024-07-28