"Application for the Installation or Replacement of a Underground Storage Tank (Ust) or Underground Storage Tank Systems" - Rhode Island

Application for the Installation or Replacement of a Underground Storage Tank (Ust) or Underground Storage Tank Systems is a legal document that was released by the Rhode Island Department of Environmental Management - a government authority operating within Rhode Island.

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  • Released on March 5, 2021;
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Application for the Installation or Replacement of a Underground
Storage Tank (UST) or Underground Storage Tank Systems
STATE OF RHODE ISLAND
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
OFFICE OF LAND REVITALIZATION AND SUSTAINABLE MATERIALS MANAGMEENT
UNDERGROUND STORAGE TANK PROGRAM
235 Promenade Street
Providence, RI 02908
(401) 222-2797
Fax: (401) 222-3813
Paperwork Requirements for UST Installation or Replacement (An owner/operator
must
apply for a certificate of registration before commencing construction. Upon receipt and
review of a complete application and installation plans, written approval will be issued.)
NOTE: This application should only be used if USTs are being replaced. For all other repairs or
modifications, including replacement of product piping, please use the form titled "Application for
the Repair or Modification of a UST System", available on our website at http://www.dem.ri.gov/ust
A completed Underground Storage Tank Registration Form
A completed Equipment List Addendum
A completed UST Installation/Modification/Upgrade Supplemental Information form
A site plan including all of the information listed below:
• Proposed locations(s) of all tanks, piping, and dispensing pumps
• Proposed location(s) of on-site monitoring or observation wells, where applicable
• Watertable elevation, where available
• Location of all public water supply wells or reservoirs within 400 feet of the facility
• Location of all facilities served by private wells or reservoirs within 200 feet of the
facility
• Location of all proposed and existing buildings and associated structures.
• Boundaries of the facility
• North arrow
Specifications or a diagram indicating depth of excavation, bedding, and backfill,
supports and anchorage used, distance between tanks, and dimensions (including
thickness) of traffic pad
Note that installation plans for new and replacement UST facilities must be
stamped by a registered Professional Engineer!
Kindly direct to the attention of:
Gregory Yekhtikian, Environmental Engineer II
Underground Storage Tank Program
(401) 222-2797 ext. 77521
Last Revised 03/05/2021
Application for the Installation or Replacement of a Underground
Storage Tank (UST) or Underground Storage Tank Systems
STATE OF RHODE ISLAND
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
OFFICE OF LAND REVITALIZATION AND SUSTAINABLE MATERIALS MANAGMEENT
UNDERGROUND STORAGE TANK PROGRAM
235 Promenade Street
Providence, RI 02908
(401) 222-2797
Fax: (401) 222-3813
Paperwork Requirements for UST Installation or Replacement (An owner/operator
must
apply for a certificate of registration before commencing construction. Upon receipt and
review of a complete application and installation plans, written approval will be issued.)
NOTE: This application should only be used if USTs are being replaced. For all other repairs or
modifications, including replacement of product piping, please use the form titled "Application for
the Repair or Modification of a UST System", available on our website at http://www.dem.ri.gov/ust
A completed Underground Storage Tank Registration Form
A completed Equipment List Addendum
A completed UST Installation/Modification/Upgrade Supplemental Information form
A site plan including all of the information listed below:
• Proposed locations(s) of all tanks, piping, and dispensing pumps
• Proposed location(s) of on-site monitoring or observation wells, where applicable
• Watertable elevation, where available
• Location of all public water supply wells or reservoirs within 400 feet of the facility
• Location of all facilities served by private wells or reservoirs within 200 feet of the
facility
• Location of all proposed and existing buildings and associated structures.
• Boundaries of the facility
• North arrow
Specifications or a diagram indicating depth of excavation, bedding, and backfill,
supports and anchorage used, distance between tanks, and dimensions (including
thickness) of traffic pad
Note that installation plans for new and replacement UST facilities must be
stamped by a registered Professional Engineer!
Kindly direct to the attention of:
Gregory Yekhtikian, Environmental Engineer II
Underground Storage Tank Program
(401) 222-2797 ext. 77521
Last Revised 03/05/2021
U S T I N S T A L L A T I O N / M O D I F I C A T I O N / U P G R A D E
S U P P L E M E N T A L I N F O R M A T I O N
Facility Name:
RI DEM UST Facility ID #:
Steel USTs equipped with a galvanic cathode system are required to be monitored in
three (3) year intervals to determine that the tank-to-soil potential reading relative to
copper is -850 millivolts or more negative. Please submit a recent corrosion evaluation
of all sti-P
USTs to be re-piped and/or interior-lined. (Potential readings are to be
3
performed by a person certified by the National Association of Corrosion Engineers
(NACE International) as a Senior Corrosion Technologist or Corrosion Technologist.)
Please verify that all newly-installed piping shall be pressure tightness-tested before
being covered, in accordance with NFPA 30 3-8 (1993).
Please verify that a precision test of the entire system (tanks and a separate line test) will
be performed upon completion of the installation/upgrade and before commencing
regular UST operation.
Please supply the name of the precision testing company and the type of test method
used. (Both the tester and test method are required to be approved in the State of Rhode
Island.)
Please supply specifications or a diagram indicating depth of excavation, bedding, and
backfill, supports and anchorage used, distance between tanks, and dimensions
(including thickness) of traffic pad.
Please supply the name of the tank/piping installer (required to be certified by the
equipment manufacturer and licensed as may be required by the R.I. Department of
Labor, Division of Professional Regulation) (please supply documentation) along with the
name of the electrical contractor.
Tank/piping installer:
Electrical contractor:
__________________________
Name
__________________________
Signature
__________________________
Date
E Q U I P M E N T L I S T A D D E N D U M
Facility Name:
RI DEM UST Facility ID #:
Date:
ITEM
MFG./VENDOR
MODEL #
QUANTITY
ADDITIONAL INFORMATION
Tank (360° Secondary Contain-
ment Required)
Primary Product Pipe & Fittings
Secondary Pipe & Fittings
Vent Pipe & Fittings
Flex Connectors
Pipe Thread Sealant/Pipe
Adhesive
Piping Sump/Transition Sump
Sump Entry/Termination Boots
and Penetration Fittings
Dispenser Sump/Pan
Sump/Pan Entry/Termination
Boots and Penetration Fittings
Spill Containment Basin
Tank Fill Identifier
Tank Monitor
Tank Volume Probe
Tank Interstitial Sensor
Piping Sump Sensor
Dispenser Sump Sensor
Remote Alarm Enunciator
Product Pump
Ball Float Valve
Extractor Valve
Automatic Fill Shut-Off
Fill Tube
Crash/Shear Valve (Pressure)
Line Leak Detector
Check Valve (Suction)
Monitoring Wells
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