UST Forms & Guidance

NOTIFICATION
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.
TANK CLOSURE PACKET
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  
OPERATIONAL COMPLIANCE
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.
STANDARDIZED INSPECTION AND TECHNICAL CHAPTERS

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.

FUND AND REIMBURSEMENT
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  
RELEASE
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
TECHNICAL GUIDANCE DOCUMENTS (TGDs)

TGD 001 - Minimum Requirements for the Number of Soil Samples Taken for Laboratory Analysis from Soil Borings - RESCINDED

TGD 002 - Division of Water Supply's Primary and Secondary Drinking Water Standard

TGD 004 - Requirements for Free Product Removal (Rev. Nov. 1, 2007)

TGD 005 - Sampling requirements for excavated material

TGD 006 - Standard Drilling Log

TGD 007 - Monitoring at UST Sites

TGD 009 - Requirements to Treat Petroleum Contaminated Soil Generated from Releases from USTs.

TGD 010 - Procedures to Obtain an NPDES Permit at a Petroleum UST Site and the Division's Interim Requirements

TGD 011 - Procedures to Determine the Applicable Soil and Ground Water Clean-up Levels During an UST System Closure - RESCINDED July 1, 2005

TGD 012 - General Facility Site Check

TGD 013 - Fund Eligibility Site Check

TGD 016 - Mobile Enhanced Multi-Phase Extraction

TGD 017 - Risk Based Corrective Action

TGD 018 - Requirements for Conducting Soil Gas Surveys

TGD 019 - Impacted Drinking Water Management

TGD 020 - Petroleum Vapor Management

WHO TO CALL: CONTRACTORS, VENDORS, AND TESTERS
Form Description Link
Approved Corrective Action Contractor List CAC List
Cathodic Protection Testers serving Tennessee January 2016
Corrosion Protection Experts serving Tennessee January 2016
New Mileage and Lodging Rates Effective May 2015

In May of 2015 new mileage and lodging rates for reimbursement went into effect.

Schedule of New Rates