UST Forms and Guidance

Form DescriptionForm Number and Link Form Description
Pre-Installation Notification FormCN-1288Form required to inform the Division of your intent to install tanks at a new facility
Amended Notification FormCN-1260Form required to Amend information about the tanks at an existing facility
Buyers Notification FormCN-1392Form to be filled out and submitted by the buyer of a registered facility
Sellers Change of Ownership FormCN-0911Form to be filled out by the seller of a registered facility 
Change of Address Form CN-1383Form to be filled out and submitted when the address of the owner or the facility is changed
Indicia of Ownership FormCN-1186 
Form Description (Resources needed to close tanks.)Form/LinkInstructions

Closure Packet Instructions

Rev. July 2005

Instructions for Closure Packet.

Please submit Permanent Closure Applications to: closure.application.ust@tn.gov

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RESCINDED July 1, 2005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

 
Form DescriptionForm/LinkInstructions
Compliance Tool BoxLINKLatest edition of Compliance Tool Box
UST Tank Owner Quick Refernce GuideLINK 
Tank Tightness Testing ReportCN-1601Tank Tightness Testing Report form can be used for release detection, repair, release investigation, or new installation.
Precision Line Tightness And Leak Detector Test ReportCN-1341Line Tightness & Leak Detector Test that can be used for release detection, repair, release investigation, or new installation.
Impressed Current Cathodic Protection Rectifier Reading FormCN-128260-Day Log for Impressed Current Systems
Impressed Current Cathodic Protection Testing SurveyCN-13093-Year Impressed Current Cathodic Protection Test
Galvanic Cathodic Protection Testing SurveyCN-11403-Year Galvanic Cathodic Protection Test
Monthly Spill Bucket Inspection LogCN-1286 
Spill Prevention Device Hydrostatic Test ReportCN-1366This form can be used to record hydrostatic testing of spill buckets.
Quarterly Dispenser Inspection LogCN-1287 
Monthly Electronic Interstitial Monitoring ReportCN-1340This form is used for Interstitial Monitoring release detection.
Annual Electronic Interstitial Monitoring Test ReportCN-1339 
Manual Tank Gauging Monthly ReportCN-1367This form can be used to record monthly Manual Tank Gauging Reports.
Preparing For A Compliance InspectionLINK 
Ethanol Equipment Compatibility ChecklistCN-1285
(Rev. Oct. 2021)		 
Statement Of CompatibilityCN-1283This form is used for indicating that the UST system components will be compatible with the product stored.
Visual Inspection For Incompatible Dispenser ComponentsCN-1284This form is used for recording daily visual inspections of incompatible dispenser components.
Monthly/Annual Facility Walkthrough Inspection FormCN-2544This form is used to document monthly or annual walkthrough inspections required under rule 0400-18-01-.02(8).
Overfill Inspection FormCN-2584Test procedure to ensure USTs cannot be overfilled (exceeding regulatory requirements).
Annual ATG Operability Test FormCN-2624This form can be used to record the annual ATG operability test results.
Low Level Hydrostatic Sump Testing FormCN-2644 
Containment Sump Integrity Hydrostatic Test ReportCN-2664 

Last revised in 2022 primarily due to October 13, 2018 rule changes, the Standardized Inspection Manual (SIM) is a standard operating procedure and a helpful resource for not only Division inspectors who conduct operational compliance inspections throughout the state, but also written for tank owners, operators and service providers. More specifically, the SIM includes a step-by-step process to help inspectors understand what they should look for at each facility, standard policies for Division employees, the Tank Owner Quick Reference Guide, and the Tank Operator Reference Guide.

Technical Chapters of every release detection (RD) method and release prevention requirement provide 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 new standardized fillable forms for several RD methods as well as required testing that include the minimum required information. The 2022 version of the SIM has been compiled as a single, searchable, hyperlinked, and indexed portable document file. Use Adobe Reader™ or other Adobe software products to take full advantage of these advanced features that allow needed information to be found more quickly and completely than ever before.

Since the early drafts of the original SIM in 2009, the SIM has been composed and revised in a collaborative effort with our regulated community and service providers. The Division has conducted a variety of outreach activities seeking feedback and input; mass postal mailings, email marketing, stakeholder meetings, webinars, web page postings of draft documents, forms, and webinar recordings. We are grateful to all who contributed to improve our final revised product.

The revision date of this manual is June 17, 2022.  This version is a “living document” being updated as needed in the future with guidance, feedback, and input from our staff and all our stakeholders. However, our staff and regulated community will be kept informed mainly through email marketing releases with special emphasis on revisions initiated due to rule or statutory requirement changes. While this manual provides consistent guidance to our inspectors and predictability to our regulated community and service providers, regulatory requirements are only those that are specified under the authority of rule or statute. Rule and/or statutory requirements are noted with footnotes and/or in the body of the text of each technical chapter.

The SIM includes:

LINKS:

Form Description

Form/Link

Instructions

Reimbursement Guidance Documents

RGD-002
(Effective 05/20/2022)

 

Task Cost Sheets

RGD-002 - Attachment I
(Effective 05/20/2022)

 

Certification Affidavits for Electronic Reimbursement Applications

CN-0923

See Reimbursement Guidance Documents

Application For Fund Eligibility

APPLICATION FOR RELEASES THAT OCCURRED ON OR AFTER APRIL 9, 2026

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 a release is suspected, even if all the confirmation steps have not been taken.

 

Tax Identification Number 

 

Federal W-9
(Rev. March 2024)		For to be submitted to the Division so that eligible costs can be reimbursed. 
Cost Database for Submittal (May 2022) - New
 

32 Bit Access
64 Bit Access

Use this version of the cost database when no previous data exist.

Cost Database for Submittal (May 2022) - Existing32 Bit Access
64 Bit Access		Use this version of the cost database to transfer data

Approved Corrective Action Contractor List

CAC List

Revised August 27, 2025

Form Description

Form/Link

Corrective Action Contractor Information

 
 

Approved Corrective Action Contractor List (Revised September 21, 2026)

CAC List

 

Application for Approved Corrective Action Contractor Status

CN-0945
(Rev. Sep. 2024)

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

Corrective Action System Deactivation ChecklistLink

Hazard Notification Report Form

CN-1259

Chemicals Of Concern

Reference 1

Form Description

Link

Approved Corrective Action Contractor List (Revised September 21, 2026)

CAC List

Cathodic Protection Testers serving Tennessee

CP Tester List

Corrosion Protection Experts serving Tennessee (Revised February 17, 2026)

CP Experts list

New lodging and Per Diem rates are effective as of January  01, 2022. Please use the link below and see page 13 for the latest rates.

TN Travel Policy

The Division's new GIS Dataviewer is now online. We are consistently and constantly updating our data. When data is updated on our systems, it takes up to 48 hours to appear in the dataviewer. The dataviewer can be found at : https://tdeconline.tn.gov/USTActiveInactive_public/. 

This section will contain forms that are currently under review and are in draft form only. The forms are being posted for the regulated community and the public to become familiar with the new forms that will be required in the future. Updates to this section will occur when new items are available.

Form DescriptionForm LinkSpecific Form Instructions
None at this time 

This Page Last Updated: September 21, 2026 at 2:43 PM