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UST Forms & Guidance

Form Description Form/Link Instructions
Pre-Installation
Notification Form
CN-1288 Payment of fees must accompany this form.
Notification For Underground Storage Tanks CN-1260 Register unregistered tanks, closures, upgrades, new installations, new ownership and name or mailing address changes.

A change in tank status such as from "currently in use" to "temporarily out of use" must also be reported on this form.

The law requires that changes be reported within thirty (30) days.
Change Of Owner Mailing Address, Amended Notification CN-1383 This Form is a simple one page form that can be used to change the mailing address of the owner.
Seller Reporting Change Of Ownership Of Tanks CN-0911 A registered owner who has just sold tanks is also required to report that change within thirty (30) days.

This one-page form should be completed by the seller.

Note that this form includes a place for the seller to report how the buyer was informed of notification requirements by the seller.

Informing the buyer is also required by law.
Buyer's Notification CN-1392  
Notification Of Indicia Of Ownership CN-1186 A lender or lending institution who has acquired tanks through foreclosure or other acquistion and who has no intention to operate the tank must report the acquisition of tanks on this one page form.
Voluntary Registry Form & Instructions CN-1267 Voluntary Registry sign up information.
E-85 Information Instructions LINK Information on ethanol blended fuels and forms.
Form Description (Resources needed to close tanks.) Form/Link Instructions

Closure Packet Instructions

Rev. July 2005

Instruction for Closure Packet.

UST System Closure Assessment Guidelines

Rev. Sept. 2006

When closing tanks, complete the "Closure Application".

Submit the application to the appropriate Field Office for approval 30 days prior to closing the UST system.

After tanks are out of the ground or properly closed in place, be sure to file an amended notification form with TN UST.

This stops the automatic billing procedure for annual tank registration.

(Note Corrected values on Table 5 effective April 1, 2007)

Application For Permanent Closure Of Underground Storage Tanks

CN-0928
Rev. July 2005

 

Permanent Closure Report

CN-0927
Rev. Apr. 2007

 

Application To Treat Petroleum Contaminated Soil By Mobile Thermal Treatment

July 1, 2005

 

Application To Treat Petroleum Contaminated Soil By Aeration

July 1, 2005

 

Approved Methods For Analysis Of Soil And Water Samples

LINK

 

Field Office Location Map

LINK

 

TGD-005 Sampling Requirements For Excavated Material

TGD-005
Rev. July 1, 2005

 

TGD-009 Requirements To Treat Petroleum Contaminated Soil Generated From Releases From Underground Storage Tanks

TGD-009
Rev. July 1, 2005

 

TGD-011 Procedures To Determine The Applicable Soil And Ground Water Cleanup Levels During An Underground Storage Tank System Closure

TGD-011
RESCINDED July 1, 2005

 

Chemicals Of Concern

Reference 1

 

Tennessee PAH List

Reference 2

 
Form Description Form/Link Instructions
Compliance Tool Box LINK Latest edition of Compliance Tool Box
UST Owner Compliance Manual LINK  
Precision Line Tightness And Leak Detector Test Report CN-1341 Line Tightness & Leak Detector Test that can be used for release detection, repair, release investigation, or new installation.
Impressed Current Cathodic Protection Rectifier Reading Form CN-1282 60-Day Log for Impressed Current Systems
Impressed Current Cathodic Protection Testing Survey CN-1309 3-Year Impressed Current Cathodic Protection Test
Galvanic Cathodic Protection Testing Survey CN-1140 3-Year Galvanic Cathodic Protection Test
Monthly Spill Bucket Inspection Log CN-1286  
Spill Prevention Device Hydrostatic Test Report CN-1366 This form can be used to record hydrostatic testing of spill buckets.
Quarterly Dispenser Inspection Log CN-1287  
Monthly Electronic Interstitial Monitoring Report CN-1340 This form is used for Interstitial Monitoring release detection.
Annual Electronic Interstitial Monitoring Test Report CN-1339  
Manual Tank Gauging Monthly Report CN-1367 This form can be used to record monthly Manual Tank Gauging Reports.
Preparing For A Compliance Inspection LINK  
Ethanol Equipment Compatibility Checklist CN-1285
(Rev. July 2010)
 
Statement Of Compatibility CN-1283 This form is used for indicating that the UST system components will be compatible with the product stored.
Visual Inspection For Incompatible Dispenser Components CN-1284 This form is used for recording daily visual inspections of incompatible dispenser components.

The Division began development of a Standardized Inspection Manual in early 2009 in order to provide effective assistance to our regulated community and to insure consistency of our inspection program statewide. In addition, previously issued Compliance Guidance Documents required much needed updating to provide the necessary technical information for inspectors, the regulated community and their service providers on how to comply with requirements. After draft developments were complete in 2011, the Division sought feedback from various stakeholders including two separate mass mailings to all registered tank owners over a two year period. Service providers also provided valued feedback. The Division continued stakeholder meetings over the past four years incorporating suggestions to the manual and developing additional outreach materials for the regulated community. We are grateful to all who contributed to improve our final product. The manual has now been finalized and is effective October 1, 2015.

The manual is intended to be a standard operating procedure and helpful resource for Division inspectors and includes a step by step process to help them understand what they should look for at each facility as well as standard policies for employees. Technical Chapters of every release detection (RD) method and release prevention requirement provide more detail on the types of equipment and related records as well as photographs illustrating what is routinely found at UST facilities. These chapters also discuss specific manufacturers’ requirements that are referenced in the Division regulations. The manual also includes previously developed as well as some new standardized fillable forms for several RD methods as well as required testing that include the minimum required information.

Form Description

Form/Link

Instructions

Reimbursement Guidance Documents

RGD-002
(Rev. April 15, 2014)

 

Task Cost Sheets

RGD-002

 

Blank Signature Pages For Electronic Reimbursement Applications

CN-0923

See Reimbursement Guidance Documents

Application For Fund Eligibility

CN-0943
(Rev. June 2008)

Application for Fund Eligibility Deadline –
The UST Act establishes a deadline for tank owners, tank operators or petroleum site owners to file an Application for Fund Eligibility.

If the application form is not received by the UST Division by the deadline established by law, the release WILL NOT BE FUND ELIGIBLE. The application must be received:
Within 60 days of a release which was identified in any manner other than the process for confirmation of a suspected release in the regulations;

or

Within 90 days of the discovery of evidence of a suspected release which is subsequently confirmed in accordance with the regulatory requirements.

NOTE: The 90 day deadline applies even if confirmation of a release does not occur within 90 days of the discovery of evidence of a suspected release.

An application should be filed as soon as possible after arelease is suspected, even if all the confirmation steps have not beentaken.

Cost Database

32 Bit Access
64 Bit Access

For submittal

Approved Corrective Action Contractor List

CAC List

 

Form Description

Form/Link

Corrective Action Contractor Information

 
 

Approved Corrective Action Contractor List

CAC List

 

Application for Approved Corrective Action Contractor Status

CN-0945
(Rev. Feb. 2017)

Guidelines, Forms, And Technical Guidance Documents

 
 

Site Check Report Guidelines

Aug. 1996

 

Environmental Assessment Guidelines

Sept. 2006

 

Initial Site Characterization Guidelines - Parts A and B

LINK

 

Initial Response and Hazard Management Report Guidelines - Part A

Sept. 2006

 

Initial Site Characterization Report Guidelines

Sept. 2006

 

Corrective Action Plan Guidelines

Jan. 2010

 

Corrective Action Plan Cost Sheets

Link

 

Corrective Action System Figures - 2010

 
   

TDEC Air Lift CAS Figure Package

LINK

   

TDEC Groundwater Pump CAS Figure Package

LINK

   

TDEC Standard CAS Figure Package

LINK

Corrective Action System Workbook

LINK

Hazard Notification Report Form

CN-1259

Chemicals Of Concern

Reference 1

Tennessee PAH List

Reference 2

Form Description

Link

Approved Corrective Action Contractor List

CAC List

Cathodic Protection Testers serving Tennessee

September 2017

Corrosion Protection Experts serving Tennessee

January 2016

In October of 2017, new lodging  and per diem rates for reimbursement went into effect. The new rates are located on page 12 of the  document below.

Schedule of New Rates