Form UST-8 "Notification for Activities Involving Underground Storage Tank Systems (Usts)" - North Carolina

What Is Form UST-8?

This is a legal form that was released by the North Carolina Department of Environmental Quality - a government authority operating within North Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2018;
  • The latest edition provided by the North Carolina Department of Environmental Quality;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form UST-8 by clicking the link below or browse more documents and templates provided by the North Carolina Department of Environmental Quality.

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Download Form UST-8 "Notification for Activities Involving Underground Storage Tank Systems (Usts)" - North Carolina

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NOTIFICATION FOR ACTIVITIES INVOLVING
UST-8
UNDERGROUND STORAGE TANK SYSTEMS (USTs)
NC DEQ / DWM / UST SECTION
STATE USE ONLY
1646 MAIL SERVICE CENTER
RETURN
RALEIGH, NC 27699-1646
I.D. #_____________________
COMPLETED
ATTN: REGISTRATION & PERMITTING
FORM
PHONE (919) 707-8171
FAX (919) 715-1117
County____________________
TO:
http://www.wastenotnc.org/
Underground Storage Tank (UST) system owners and operators are
Which USTs are included?
required by federal and state law to provide notification for all UST systems
Regulated and/or commercial USTs, including the following:
that were in the ground on or after May 8, 1986, unless taken out of
USTs used to store or resell petroleum product (e.g., motor fuels, jet
operation on or before January 1, 1974. In addition, registration of
fuels, waste oil, kerosene, varsol, transmission fluid, mineral spirits,
commercial USTs in use on or after January 1, 1989 is necessary to comply
gasohol, etc.)
with state law (N.C.G.S. 143-215.94C).
Heating oil USTs > 1,100 gallons (gals)
Farm or residential USTs > 1,100 gals
A UST system owner is: (a) in the case of a UST system in use on
Emergency generator USTs
November 8, 1984, or brought into use after that date, any person who owns
Hydraulic lift USTs
a UST system used for storage, use, or dispensing of regulated substances;
Oil-water separator USTs (containing petroleum in amounts > 1% of
and (b) in the case of any UST system in use before November 8, 1984, but
tank capacity)
no longer in use on that date, any person who owned such UST immediately
Hazardous substance USTs > 110 gals (e.g., alcohols, naphthalene,
before the discontinuation of its use.
dry cleaning fluids, antifreeze, formaldehyde, hexane, etc.)
A UST system operator is any person in control of, or having responsibility
Airport Hydrant Fuel Distribution Systems
for, the daily operation of a UST system.
USTs with Field Constructed Tanks
The primary purpose of this notification form is to obtain and update
Which USTs are excluded?
information on UST system locations, ownership, construction, product
Certain tanks are not included in these notification requirements. These
stored, leak detection and corrosion protection methods, etc. and to facilitate
tanks include the following: small home heating oil and farm tanks ( 1,100
permitting and the payment of annual operating fees. It is expected that the
gals), large heating oil tanks (> 1,100 gals) if used to heat four or fewer
information provided will be based on reasonably available records, or, in the
households and located on premises where used, septic tanks, storm water
absence of such records, personal knowledge, belief, or recollection.
or waste water collection systems, flow-through process tanks, and tanks
situated in an underground area (such as a basement, cellar, mine, shaft,
vault or tunnel) if the tank is situated upon or above the surface of the floor.
INSTRUCTIONS
Please type or print all items except signature. This form must be completed by an owner or operator for each facility containing UST systems. If more than
four (4) UST systems are owned at a facility, photocopy the necessary additional sheets and staple to this form.
Complete sections I through VI.A. and IX completely. Then only complete the applicable sections of VI.B. through VIII.
I. OWNERSHIP OF UST SYSTEM
II. OPERATOR OF UST SYSTEM
Check if same as owner
Owner Name (Corporation, Individual, Public Agency, or Other Entity)
Operator Name (Corporation, Individual, Public Agency, or Other Entity)
Contact Name (if not named above)
Contact Name (if not named above)
Street Address
Street Address
City
State
Zip Code
City
State
Zip Code
WY
WY
County
County
Yancey
Yancey
Phone Number
Fax Number
Phone Number
Fax Number
Email Address
Email Address
Check here if "Real" Property Owner of Site
Check here if "Real" Property Owner of Site
Type of UST owner (check all that apply):
State Gov't
Local Gov't
Private/Corporate
GSA Facility ID
Federal Gov't
III. TYPE OF NOTIFICATION (check all that apply)
Change of Ownership
Amendment of a previous registration form. (Complete only the items
A "Change of Ownership" form, UST-15 along with copies of the legal
in the sections that follow that have changed from a previous UST-6 or
documents showing the transfer of tank ownership (e.g., bill of sale,
UST-8 submittal)
property deed, etc.) must accompany this form.
Temporary closure (Complete section VII)
Failure to complete a UST-15 will result in no effective change of
ownership status
Existing Facility with UST system not previously registered
(see fee payment instructions at the bottom of Page 6).
UST-8
1
Revised 3/20/2018
NOTIFICATION FOR ACTIVITIES INVOLVING
UST-8
UNDERGROUND STORAGE TANK SYSTEMS (USTs)
NC DEQ / DWM / UST SECTION
STATE USE ONLY
1646 MAIL SERVICE CENTER
RETURN
RALEIGH, NC 27699-1646
I.D. #_____________________
COMPLETED
ATTN: REGISTRATION & PERMITTING
FORM
PHONE (919) 707-8171
FAX (919) 715-1117
County____________________
TO:
http://www.wastenotnc.org/
Underground Storage Tank (UST) system owners and operators are
Which USTs are included?
required by federal and state law to provide notification for all UST systems
Regulated and/or commercial USTs, including the following:
that were in the ground on or after May 8, 1986, unless taken out of
USTs used to store or resell petroleum product (e.g., motor fuels, jet
operation on or before January 1, 1974. In addition, registration of
fuels, waste oil, kerosene, varsol, transmission fluid, mineral spirits,
commercial USTs in use on or after January 1, 1989 is necessary to comply
gasohol, etc.)
with state law (N.C.G.S. 143-215.94C).
Heating oil USTs > 1,100 gallons (gals)
Farm or residential USTs > 1,100 gals
A UST system owner is: (a) in the case of a UST system in use on
Emergency generator USTs
November 8, 1984, or brought into use after that date, any person who owns
Hydraulic lift USTs
a UST system used for storage, use, or dispensing of regulated substances;
Oil-water separator USTs (containing petroleum in amounts > 1% of
and (b) in the case of any UST system in use before November 8, 1984, but
tank capacity)
no longer in use on that date, any person who owned such UST immediately
Hazardous substance USTs > 110 gals (e.g., alcohols, naphthalene,
before the discontinuation of its use.
dry cleaning fluids, antifreeze, formaldehyde, hexane, etc.)
A UST system operator is any person in control of, or having responsibility
Airport Hydrant Fuel Distribution Systems
for, the daily operation of a UST system.
USTs with Field Constructed Tanks
The primary purpose of this notification form is to obtain and update
Which USTs are excluded?
information on UST system locations, ownership, construction, product
Certain tanks are not included in these notification requirements. These
stored, leak detection and corrosion protection methods, etc. and to facilitate
tanks include the following: small home heating oil and farm tanks ( 1,100
permitting and the payment of annual operating fees. It is expected that the
gals), large heating oil tanks (> 1,100 gals) if used to heat four or fewer
information provided will be based on reasonably available records, or, in the
households and located on premises where used, septic tanks, storm water
absence of such records, personal knowledge, belief, or recollection.
or waste water collection systems, flow-through process tanks, and tanks
situated in an underground area (such as a basement, cellar, mine, shaft,
vault or tunnel) if the tank is situated upon or above the surface of the floor.
INSTRUCTIONS
Please type or print all items except signature. This form must be completed by an owner or operator for each facility containing UST systems. If more than
four (4) UST systems are owned at a facility, photocopy the necessary additional sheets and staple to this form.
Complete sections I through VI.A. and IX completely. Then only complete the applicable sections of VI.B. through VIII.
I. OWNERSHIP OF UST SYSTEM
II. OPERATOR OF UST SYSTEM
Check if same as owner
Owner Name (Corporation, Individual, Public Agency, or Other Entity)
Operator Name (Corporation, Individual, Public Agency, or Other Entity)
Contact Name (if not named above)
Contact Name (if not named above)
Street Address
Street Address
City
State
Zip Code
City
State
Zip Code
WY
WY
County
County
Yancey
Yancey
Phone Number
Fax Number
Phone Number
Fax Number
Email Address
Email Address
Check here if "Real" Property Owner of Site
Check here if "Real" Property Owner of Site
Type of UST owner (check all that apply):
State Gov't
Local Gov't
Private/Corporate
GSA Facility ID
Federal Gov't
III. TYPE OF NOTIFICATION (check all that apply)
Change of Ownership
Amendment of a previous registration form. (Complete only the items
A "Change of Ownership" form, UST-15 along with copies of the legal
in the sections that follow that have changed from a previous UST-6 or
documents showing the transfer of tank ownership (e.g., bill of sale,
UST-8 submittal)
property deed, etc.) must accompany this form.
Temporary closure (Complete section VII)
Failure to complete a UST-15 will result in no effective change of
ownership status
Existing Facility with UST system not previously registered
(see fee payment instructions at the bottom of Page 6).
UST-8
1
Revised 3/20/2018
UST-8
NOTIFICATION FOR ACTIVITIES INVOLVING UNDERGROUND STORAGE TANK SYSTEMS (USTs)
IV. LOCATION OF UST SYSTEM
Facility Name or Company
Indicate number of regulated tanks at this location
Street Address
Indicate total number of tanks at this location
City
Zip Code
Check box if tanks are located on land within an Indian reservation
or on other Indian lands
County
Phone Number
Yancey
County Tax Map Number:
Are any UST systems at this facility located
 Yes
 No
within 500 feet of a water supply well?
Facility ID (if known):
V. CONTACT PERSON FOR UST LOCATION
Name
Job Title
Phone Number
VI. DESCRIPTION OF ALL UST OR COMPARTMENT SYSTEMS AT THIS FACILITY
A. UST Information
Tank/Compartment ID#
Tank No.
Tank No.
Tank No.
Tank No.
(e.g., A, B, C or 1, 2, 3; If compartment tank
1A, 1B, 1C, etc.)
Date of Installation
Tank Manufacturer
Tank Model
SW Steel/Polyurethane
SW Steel/Polyurethane
SW Steel/Polyurethane
SW Steel/Polyurethane
1
Materials of construction
If Other (specify)
Field Constructed Tank
Capacity (gallons)
If compartment tank, list compartment size.
Check if tank is siphon manifolded and enter
/
/
/
/
tank # it is manifolded with.
Used Oil
Used Oil
Used Oil
Used Oil
2
Product stored
If Hazardous substance, Chemical Abstract
Service (CAS) number
Other (specify)
1
Enter one of the following in the space provided: DW* FRP*** (e.g., Xerxes, Containment Solutions), DW* Steel, DW* Steel/FRP*** (e.g., ACT-100), DW* Steel/Polyurethane
(e.g. ACT-100-U), DW* Steel/Jacketed (e.g., Permatank, Titan), Other, SW** FRP*** (e.g., Xerxes, Containment Solutions), SW** Steel, SW** Steel/FRP*** (e.g., ACT-100),
SW** Steel/Polyurethane (e.g., ACT-100-U)
*DW = Double-walled **SW = Single-walled ***FRP = Fiberglass Reinforced Plastic
2
Enter one of the following in the space provided: Aviation Gas, Biodiesel (> 20%) - Diesel Mix, Diesel, Ethanol (> 10%) -Gas Mix, Fuel Oil, Gasoline, Hazardous Substance,
Heating Oil, Kerosene, Motor Oil, Other Non-Petroleum, Other Petroleum, Transmission Fluid, or Used Oil
B. Piping System
Tank No.
Tank No.
Tank No.
Tank No.
Piping Manufacturer
Piping Model
SW Steel
SW Steel
SW Steel
SW Steel
1
Material of Construction
If Other (specify)
Airport Hydrant System
Gravity
Gravity
Gravity
Gravity
Piping configuration (Pressurized, Suction,
European Suction, Gravity)
Both
Both
Both
Both
If suction, check valve located at? (Tank,
Dispenser, or Both)
1
Enter one of the following in the space provided: DW* Flex (e.g., APT XP, Environ GeoFlex), DW* FRP (e.g., Ameron Dualoy, Smith Fibercast Red Thread IIA), DW*
Metal/Plastic (e.g., PetrofuseZP), DW* PVC, DW* Steel, None, Other, SW** Copper, SW** Flex, SW** FRP, SW** PVC, SW** Steel
*DW = Double-walled **SW = Single-walled ***FRP = Fiberglass Reinforced Plastic
UST-8
2
Revised 3/20/2018
UST-8
NOTIFICATION FOR ACTIVITIES INVOLVING UNDERGROUND STORAGE TANK SYSTEMS (USTs)
C. Under Dispenser Containment (UDC)
Enter the dispenser number(s) in each column that will have the same make/model of dispenser UDC. If all dispenser UDCs will be the same then enter
“ALL” as the number in column 1 and complete only column 1. Dispensers with the same UDCs only must be entered in one of the columns with a list of the
dispensers that have that model UDC.
Dispenser #(s)
Dispenser #(s)
Dispenser #(s)
Dispenser #(s)
UDC Manufacturer
UDC Model
DW
DW
DW
DW
1
Is UDC Single (SW) or Double Walled (DW)?
None
None
None
None
2
Method of monitoring UDC
Other
Other
Other
Other
3
UDC Material of Construction
If Other (specify)
1
Enter one of the following choices: SW (single-walled) or DW (double-walled)
2
Enter one of the following choices: Sump Sensor, Vacuum, Pressure, Hydrostatic, or None
3
Enter one of the following choices: Plastic, FRP (Fiberglass Reinforced Plastic), Other
1
D. Leak detection (LD)
[Check any box or combination of boxes that apply] [Refer to 15A NCAC 2N .0504, .0505, and .0900]
Mark all that apply
Tank No.
Tank No.
Tank No.
Tank No.
Tank
Piping
Tank
Piping
Tank
Piping
Tank
Piping
a. Automatic tank gauging
2
b. Manual tank gauging
c. Interstitial monitoring
Hydrostatic
Hydrostatic
Hydrostatic
Hydrostatic
Hydrostatic
Hydrostatic
Hydrostatic
Hydrostatic
1
i. Method of Monitoring Interstice
d. Statistical inventory reconciliation
3
e. Groundwater monitoring every 14 days
f. Vapor monitoring every 14 days
4
g. Automatic line leak detector
i. Mechanical line leak detector
ii. Electronic line leak detector
h. Periodic line tightness testing
i.
Exempt under 40 CFR 280.41 (b) (2) (i)-
(iv) (this exemption applies only to
"European" suction systems)
j.
Automatic tank gauging and Tank
5
Tightness Testing
5
k. Vapor Monitoring with Tracer compound
l.
Inventory Control per DoD 4140.25 and
5
one of the following:
5
i.
Tank Tightness Test
5
ii. Line Tightness Test
5
iii. Vapor Monitoring
5
iv. Ground Water Monitoring
m. Other state approved method (specify):
n. Leak detection not required at this facility
because: the UST system at this facility is
not regulated (e.g., UST system at this
facility stores heating oil for onsite use).
o. Leak detection not required at this facility
because: the UST system at this facility is
a wastewater treatment tank system (e.g.
oil/water separator tank).
UST-8
3
Revised 3/20/2018
UST-8
NOTIFICATION FOR ACTIVITIES INVOLVING UNDERGROUND STORAGE TANK SYSTEMS (USTs)
D. Leak detection (LD)
(Continued)
Tank No.
Tank No.
Tank No.
Tank No.
Date leak detection method above initiated
Monitoring console manufacturer/model
Automatic line leak detector manufacturer
/model
Interstitial sensor manufacturer/model – tank
Interstitial sensor manufacturer/model – piping
Interstitial sensor manufacturer/model – spill
prevention equipment
Enter the dispenser number(s) in each column that will have the same make/model of interstitial sensor. If all dispenser interstitial sensors will be the same
then enter “ALL” as the number in column 1 and complete only column 1. Dispensers with the same interstitial sensors only must be entered in one of the
columns with a list of the dispensers that have that model interstitial sensor.
Dispenser #(s)
Dispenser #(s)
Dispenser #(s)
Dispenser #(s)
Interstitial sensor manufacturer/model – UDC
1
Interstitial monitoring leak detection is required for all UST systems installed on or after 11/1/2007. You must enter one of the following choices - Tank:
Vacuum, Pressure, or Hydrostatic; Piping: Sump sensor, Vacuum, Pressure, or Hydrostatic. Interstitial monitoring leak detection is also required for all
UST systems that store a hazardous substance or that are located between 100 and 500 feet of a public water supply well or between 50 and 100 feet
of any other well used for human consumption or within 500 feet of a protected surface water classified as High Quality Water (HQW), Outstanding
Resource Water (ORW), Water Supply I (WS-I), Water Supply II (WS-II), or Shell Fishing (SA). (The only exception is for single-walled underground
petroleum tanks in the locations described above and installed after January 1, 1991 and before May 1, 2000. Owners and operators of these tanks
may use enhanced leak detection as a temporary method until January 1, 2020. Enhanced leak detection consists of 0.2 gallon per hour weekly leak
rate tests using an automatic tank gauge plus annual sampling of supply wells within 500 feet for constituents of petroleum.)
2
This method is only valid for USTs 550-gallons or less in capacity or USTs 551-1,000 gallons that have a tank diameter of 48 or 64 inches.
3
Can only be used if groundwater is never more than 20 feet from ground surface.
4
A mechanical or electronic line leak detector is required for all pressurized piping systems. Additionally, you must either perform annual line tightness
testing or conduct a monthly monitoring method (e.g., statistical inventory reconciliation, interstitial monitoring, or 0.1 gallon per hour tests monthly using
an electronic line leak detector).
5
This method is only valid for Field Constructed Tanks and/or Airport Hydrant Fueling Systems.
E. Corrosion protection (CP)
[check any method or combination of methods that apply] [Refer to 15A NCAC 2N .0301 and .0302]
Tank No.
Tank No.
Tank No.
Tank No.
Tank
Piping
Tank
Piping
Tank
Piping
Tank
Piping
Sacrificial anodes
Impressed current
Fiberglass Reinforced Plastic (FRP)
Flexible Pipe
Steel/FRP Composite
Steel/Polyurethane Composite
Internal lining
Other (specify)
None
Date CP method above installed
F. Flexible connectors, Submersible pumps, and Riser pipes
Tank No.
Tank No.
Tank No.
Tank No.
Tank
Dispenser
Tank
Dispenser
Tank
Dispenser
Tank
Dispenser
No
No
No
No
No
No
No
No
1
Flex connector is present
No
No
No
No
No
No
No
No
1
Flex connector is isolated from the ground
None
None
None
None
None
None
None
None
If “No”, cathodic protection method
2
UST-8
4
Revised 3/20/2018
UST-8
NOTIFICATION FOR ACTIVITIES INVOLVING UNDERGROUND STORAGE TANK SYSTEMS (USTs)
F. Flexible connectors, Submersible pumps, and Riser pipes (Cont)
Tank No.
Tank No.
Tank No.
Tank No.
Tank
Dispenser
Tank
Dispenser
Tank
Dispenser
Tank
Dispenser
Submersible pump (STP) is isolated from
No
No
No
No
No
No
No
No
1
ground
(pressurized piping only)
None
None
None
None
None
None
None
None
If “No”, cathodic protection method
2
No
No
No
No
No
No
No
No
Riser pipes and/or other metal fittings are
1
isolated from ground
None
None
None
None
None
None
None
None
If “No”, cathodic protection method
2
1
Enter one of the following choices: Yes, No
2
Enter one of the following choices: IC (Impressed Current), SA (Sacrificial Anode), N (None)
G. Spill/Overfill Protection
Tank No.
Tank No.
Tank No.
Tank No.
Spill Prevention Equipment Type
Not Required
Not Required
Not Required
Not Required
(Enter Catchment Basin, None, or Not
1
Required
)
Spill Prevention Equipment Manufacturer
Spill Prevention Equipment Model
None
None
None
None
If double-walled, method of monitoring
2
interstice
Date spill prevention listed above installed
Overfill Prevention Equipment Type
Not Required
Not Required
Not Required
Not Required
(Enter Automatic shutoff, Alarm at tank,
3
1
Ball float
, None, or Not Required
)
Overfill Prevention Equipment Manufacturer
Overfill Prevention Equipment Model
Date overfill prevention listed above installed
1
Not Required is only valid for USTs that are always filled by transfers that are 25 gallons or less.
2
Enter one of the following choices :
Float sensor, Vacuum, Pressure, Hydrostatic, or None
3
Ball Floats cannot be used with coaxial vapor recovery or suction piping systems. In accordance with 15A NCAC 2N .0301, new ball float vent valves
cannot be installed after June 1, 2017.
H. Stage I Vapor Recovery (For Gasoline USTs only):
Tank No.
Tank No.
Tank No.
Tank No.
Combined annual throughput (gallons)
Coaxial system
Dual point system
Vapor recovery is not required for this UST*
Date installed
* Stage I vapor recovery equipment must be installed for all applicable gasoline USTs. [Note: the following gasoline USTs are not required to have Stage I
vapor recovery: a) tanks that are 550 gallons in capacity or less; b) tanks that are 2,000 gallons in capacity or less and that were installed before July 1,
1979; and c) tanks at facilities that have a combined annual throughput of less than 50,000 gallons per year].
VII. OUT OF OPERATION UST SYSTEMS
Tank No.
Tank No.
Tank No.
Tank No.
Date permanently closed
(removed or fill with solid, inert material)
Date temporary closure began
Date temporary closure ended
UST-8
5
Revised 3/20/2018