Leaking Underground Storage Tanks (Leaking UST) Technical Forms

Leaking Underground Storage Tank Program Form Descriptions

Supplemental Instructions to Technical Forms: These instructions should be followed when completing technical forms submitted to the Leaking Underground Storage Tank Section. This document will be updated periodically.

20-Day Certification: A one-page certification, this form assures that all immediate threats to human health have been mitigated. The owner or operator must certify that the listed items on the form are true and submit the form to the Illinois EPA's Leaking UST Section within 20 days of the reported release date.

45-Day Report: The 45-Day Report must be submitted within 45 days of the reported release date and must be contain information about the site and the nature of the release, including information gained during initial abatement measures.

Stage 1 Site Investigation Certification: The UST owner or operator and a Licensed Professional Engineer or Licensed Professional Geologist must certify that the Stage 1 site investigation will be conducted in accordance with 35 Ill. Adm. Code 734.315 and that the costs of the Stage 1 site investigation will not exceed the amounts set forth in 35 Ill. Adm. Code 734.Subpart H, Appendix D, and Appendix E. This certification is intended to meet the requirements for a plan and budget for the Stage 1 site investigation required to be submitted pursuant to 35 Ill. Adm. Code 734.315 and 734.310.

Furthermore, this certification is included with the 45-Day Report form to fulfill the requirements in 35 Ill. Adm. Code 734.315 and 734.310. The Stage 1 Site Investigation Certification form must be submitted only in cases when the Illinois EPA has not received a 45-Day Report that includes the aforementioned certification (i.e., 45-Day Reports submitted prior to March 1, 2006).

Free Product Removal: When conditions at a site indicate the presence of free product (free product means petroleum not dissolved in water), the owner or operator is required to remove as much free product as possible and submit a report within 45 days of the confirmation of the presence of free product. This report documents actions taken to remove free product and must be submitted for each occurrence of free product. If free product removal activities will continue beyond 45 days, a Free Product Removal Plan (and budget, if applicable) must be submitted.

Site Investigation Plan: A proposal for activities to investigate a site in accordance with the Part 734 regulations must be submitted to the Illinois EPA's Leaking UST Section for approval. In addition, a budget must be submitted if the owner or operator intends to seek reimbursement from the UST Fund.

Site Investigation Completion Report: Upon completion of site investigation activities, this report must be submitted.

Site Classification Work Plan: A proposal for activities to classify a site in accordance with the Part 732 regulations must be submitted to the Illinois EPA's Leaking UST Section for approval*. Owners and operators must classify the underground storage tank release site into one of three categories: No Further Action (NFA), Low Priority (LP), or High Priority (HP). The site classification determines the type of corrective action, if any, that will be necessary. In addition, a budget must be submitted if the owner or operator intends to seek reimbursement from the UST Fund.

Site Classification Completion Report: Upon completion of site classification activities, this report must be submitted and include a Professional Engineer Certification for the site to be classified as NFA, LP, or HP. Upon approval of an NFA classification, the owner and operator will receive a "No Further Remediation" letter. For LP and HP classifications, as indicated below, additional plans and reports are required.

Low Priority Groundwater Monitoring Plan: Owners and operators must propose a plan to monitor the groundwater at the site for a period of three years. In addition, a budget must be submitted if the owner or operator intends to seek reimbursement from the UST Fund.

Groundwater Monitoring Report: For sites classified as Low Priority sites only, owners and operators must submit an annual report documenting groundwater-monitoring activities.

Corrective Action Plan: An owner or operator must propose some type of corrective action for remediation of the site. In addition, a budget must be submitted if the owner or operator intends to seek reimbursement from the UST Fund.

Corrective Action Completion Report: This report describes the corrective action performed, contains sampling results, and must be accompanied by a Professional Engineer Certification. An owner and operator may request a "No Further Remediation" letter upon the completion of groundwater monitoring for a Low Priority classification, the completion of the required remediation for a High Priority classification, or the required remediation for releases subject to Part 734 regulations.

Professional Engineer Certification: A Professional Engineer must certify that the required corrective action has been completed in accordance with the requirements of Title XVI of the Environmental Protection Act, as amended by Public Act 92-0554, and that no further remediation is necessary at the site.

Laboratory Certification for Chemical Analysis: Certification by the sample collector and laboratory representative is required to be submitted with all chemical analytical results.

Laboratory Certification for Physical Soil Analysis: Certification by the sample collector and laboratory representative is required to be submitted with all physical soil analytical results included as part of a Site Classification Completion Report, Groundwater Monitoring Report (for sites classified as Low Priority) and/or Corrective Action Completion Report.

Owner/Operator Property Summary: This information is required prior to the issuance of a No Further Remediation Letter, including identification of proposed institutional controls and engineered barriers (if any), underground storage tank owner or operator declaration, property ownership declaration, and site description (legal description and real estate tax/parcel index number). This form must be submitted with a Corrective Action Completion Report.

Heating Oil UST Election: This form should be used as an official notification to the Illinois EPA of the owner's or operator's intention to either proceed or not proceed in accordance with the Leaking UST regulations.

Pre-1974 UST Notification: This form should be used to notify the Illinois EPA that the release was from a pre-1974 UST and that an OSFM order for UST removal has not been issued. The UST owner or operator may pursue an NFR Letter through either the Leaking UST Program or the SRP.

Election to Proceed under 35 Ill. Adm. Code 734: This form should be used as an official notification to the Illinois EPA of the owner's or operator's intention to proceed in accordance with Title XVI of the Environmental Protection Act, as amended by Public Act 92-0554.

Election to Proceed as "Owner":  This form should be used as an official notification to the Illinois EPA of a person's acquired ownership interest in a site and said person's intention to proceed in accordance with Title XVI of the Environmental Protection Act, as amended by Public Act 94-0274.

Land Trust Beneficial Interest Disclosure/Designation of Signature Authority: This form must be completed if the owner or operator performing corrective action is a land trust. The disclosure of beneficial interests in the land trust is required under the Land Trust Beneficial Interest Disclosure Act [765 ILCS 405]. A new disclosure form must be submitted if there is a change in any of the information provided.  Additionally, the beneficiaries must appoint one representative to act on behalf of all beneficiaries.

Soil Boring Log:  Information required by the regulations for each soil boring completed must be provided on this form.

Well Completion Report: Information required by the regulations for each groundwater monitoring well completed must be provided on this form.

SSL Input Parameters for Use with Tier 2 Calculations: This form should be used to provide the input parameters for a Tier 2 evaluation based on the SSL equations.

RBCA Input Parameters for Use with Tier 2 Calculations: This form should be used to provide the input parameters for a Tier 2 evaluation based on the RBCA equations.

Election to Proceed under the Site Remediation Program: This form applies only to owners or operators electing to conduct remediation under the Site Remediation Program.