Form ECY020-95 "Underground Storage Tank - 30 Day Notice" - Washington

What Is Form ECY020-95?

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

Form Details:

  • Released on May 1, 2019;
  • The latest edition provided by the Washington State Department of Ecology;
  • 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 printable version of Form ECY020-95 by clicking the link below or browse more documents and templates provided by the Washington State Department of Ecology.

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Download Form ECY020-95 "Underground Storage Tank - 30 Day Notice" - Washington

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UST ID #: __________
30-D
N
AY
OTICE
County: __________
U
S
T
S
FOR
NDERGROUND
TORAGE
ANK
YSTEMS
This form provides Ecology 30-days’ advanced notice for projects, as required
by Chapter 173-360A WAC. Instructions are on the back page.
Please  the appropriate box:
Intent to Install
Intent to Close
Change-in-Service
I. S
I
II. O
/O
I
ITE
NFORMATION
WNER
PERATOR
NFORMATION
Tag or UBI # (if applicable):
Owner/Operator Name:
UST ID # (if applicable):
Business Name:
Site Name:
Mailing Address:
Site Address:
City:
State:
Zip:
City:
Phone:
Phone:
Email:
III. C
S
P
(
)
ERTIFIED
ERVICE
ROVIDER
S
Check the appropriate boxes. If more than one service provider is required
for this project, fill out both sections.
Note: Individuals performing UST services MUST be ICC-certified or have passed
another qualifying exam approved by the Department of Ecology.
1)
Installer
Decommissioner
Site Assessor
Company Name:
Certification Type:
Service Provider Name:
Cert. No.:
Exp. Date:
Provider Phone:
Provider Email:
2)
Installer
Decommissioner
Site Assessor
Company Name:
Certification Type:
Service Provider Name:
Cert. No.:
Exp. Date:
Provider Phone:
Provider Email:
IV. T
/
P
I
ANK AND
OR
IPING
NFORMATION
P
IPING
S
I
D
P
T
UBSTANCE
NSTALLATION OR
ATE
ROJECT IS
ANK
T
ID
C
ANK
OMMENTS
S
R
E
C
TORED
EPLACEMENT
XPECTED TO
APACITY
O
(Y/N)
B
NLY
EGIN
UST ID #: __________
30-D
N
AY
OTICE
County: __________
U
S
T
S
FOR
NDERGROUND
TORAGE
ANK
YSTEMS
This form provides Ecology 30-days’ advanced notice for projects, as required
by Chapter 173-360A WAC. Instructions are on the back page.
Please  the appropriate box:
Intent to Install
Intent to Close
Change-in-Service
I. S
I
II. O
/O
I
ITE
NFORMATION
WNER
PERATOR
NFORMATION
Tag or UBI # (if applicable):
Owner/Operator Name:
UST ID # (if applicable):
Business Name:
Site Name:
Mailing Address:
Site Address:
City:
State:
Zip:
City:
Phone:
Phone:
Email:
III. C
S
P
(
)
ERTIFIED
ERVICE
ROVIDER
S
Check the appropriate boxes. If more than one service provider is required
for this project, fill out both sections.
Note: Individuals performing UST services MUST be ICC-certified or have passed
another qualifying exam approved by the Department of Ecology.
1)
Installer
Decommissioner
Site Assessor
Company Name:
Certification Type:
Service Provider Name:
Cert. No.:
Exp. Date:
Provider Phone:
Provider Email:
2)
Installer
Decommissioner
Site Assessor
Company Name:
Certification Type:
Service Provider Name:
Cert. No.:
Exp. Date:
Provider Phone:
Provider Email:
IV. T
/
P
I
ANK AND
OR
IPING
NFORMATION
P
IPING
S
I
D
P
T
UBSTANCE
NSTALLATION OR
ATE
ROJECT IS
ANK
T
ID
C
ANK
OMMENTS
S
R
E
C
TORED
EPLACEMENT
XPECTED TO
APACITY
O
(Y/N)
B
NLY
EGIN
30-D
N
AY
OTICE
U
S
T
S
FOR
NDERGROUND
TORAGE
ANK
YSTEMS
G
I
ENERAL
NSTRUCTIONS
Under WAC 173-360A-0300, 173-360A-0810 and 173-360A-0820, owners and/or operators are required to notify the
Department of Ecology (Ecology) at least 30 days prior to beginning underground storage tank (UST) and/or piping
installation, decommissioning, or change-in-service projects by mailing this notice to the address below. A separate form must
be used for each project type (e.g. install, removal). Once this form is received by Ecology, it is date-stamped and returned to
the owner/operator listed on the form. Installation and decommissioning projects cannot begin within the first 30 days after the
date stamped on this form unless the wait-period has been waived by a regional Ecology UST inspector. If a project cannot
meet the deadlines described below, an additional 30-Day Notice may be required.
Department of Ecology
Underground Storage Tank Section
PO Box 47655
Olympia, WA 98504-7655
S
O
/O
I
ITE AND
WNER
PERATOR
NFORMATION
Fill in the site/owner information completely. The contact person listed on this form must confirm the exact date an installation
or decommissioning project will begin by contacting the regional UST inspector at least 3 business days before proceeding.
I
/R
T
/
P
NSTALLATION
EPLACEMENT OF
ANK AND
OR
IPING
Installation projects must begin within 90 days of the date stamped on this notice. Complete the Tank Information section by
assigning Tank ID numbers that have not previously been used at the facility. Once processed, this form allows a one-time drop
of product for UST system testing purposes only. The fuel drop is not required to occur within the 90-day period. Once your
tank(s) store more than one inch of product, leak detection equipment and monitoring must be in place.
To receive additional deliveries and operate the new tanks/piping, you must submit the
Business License
application,
UST
Addendum, and the tank/piping Manufacturer’s Installation Checklists to the Department of Revenue (DOR) within 30 days of
completing the installation. This activates the mailing of your Business License with tank endorsement(s) from DOR and the
facility compliance tag from Ecology.
If only piping is being installed or replaced piping, the ICC-certified installer must certify the installation by completing the
Retrofit/Repair Checklist
with the Manufacturer’s Installation Checklist and submitting it to the owner/operator. The form
packet must be submitted by the owner/operator to Ecology within 30 days of completing the piping installation.
P
C
T
/
P
ERMANENT
LOSURE OF
ANK AND
OR
IPING
Decommissioning projects must be completed within 90 days after the date stamped on this returned notice. Complete the Tank
Information section using Tank ID numbers listed on the Business License. Use the Comments box to include additional
information, such as the date when product was removed from both the piping and the tank to less than one inch.
Contact your local fire marshal and planning department prior to tank closure to procure any permits required by county or other
local jurisdictions. Compliance with the State Environmental Policy Act (SEPA) Rules, Chapter 197-11 WAC may also apply.
A site assessment is required at the time of closure. If contamination is not discovered, a site assessment report must be
submitted to the above address within 30 days. If contamination is discovered or confirmed, it must be reported to the
appropriate Ecology regional office within 24 hours and a site characterization report must be submitted to the above address
within 90 days.
The following are some examples of tanks that are exempt from the UST regulations.
Farm or residential tanks, 1,100 gallons or less, used to store motor fuel for personal or farm use only.
The fuel must be used for farm purposes and cannot be for resale.
Tanks used for storing heating oil that is used solely for the purpose of heating the premises.
Tanks with a capacity of 110 gallons or less.
Emergency overflow tanks, catch basins, or sumps.
If you need this document in a format for the visually impaired, call Toxics Cleanup Program at (360) 407-7170. Persons with hearing loss can call
711 for Washington Relay Service. Persons with speech disability, call (877) 833-6341.
ECY 020-95 (Revised May 2019)
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