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updated: April 2010
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Installation of monitoring wells, air injection wells, air sparging wells, and recovery wells in Guilford County
Guilford County Well Rules
Chaper 3 of the well rules is for DUMT well requirements.
DUMTCon
Construction record for wells with daily use more than 10,000 gallons
DUMT APP
Application for permit to construct a water supply well
MW Permit Application
Application for Well Installation Permit, and Well Construction Record
MW Abandonment
Well Abandonment Record
UST Forms
Corective Action
UST - 61
24-Hour Release and UST Leak Reporting Form
Soil Permiting
UST-70
Non-Discharge Permit Application for Soil Remediation Projects
UST-71
Certificate of Approval for Storage/Treatment of Soil Containing Petroleum Products
UST-72
Agreement for Land Application or Containment and Treatment of Soils Containing Petroleum Products on Private Lands
Permits and Inspections
UST-2
Site Investigation Report for Permanent Closure or Change-in-Service of UST
UST-3
Notice of Intent: UST Permanent Closure of Change-in-Service
UST-4
Notice of Intent to Install Vapor or Groundwater Monitoring System
UST-5
Site Investigation Report for Installation of Vapor or Groundwater Monitoring System
UST-6A/B
Notice of Intent to Install USTs
UST-7A
Cathodic Protection Testing form for galvanic cathodic protection systems
UST-7B
Cathodic Protection Testing form for impresses current cathodic protection systems
UST-8
Notification for Activities Involving Underground Storage Tanks
UST-10A
UST Installation Inspection Checklist
UST-10B
UST General Requirements Inspection Checklist
UST - 12
Closure Report Format Instructions
UST-13
Compartment Tank Notification
UST-15
Change of Ownership of UST System(s)
UST-15A
Ownership of UST Systems
UST-16
Manual Tank Gauging Record
UST-17A
UST Suspected Release 24 Hour Notice Form
UST-17B
UST Suspected Release 7 Day Notice Form
UST-18
Application for Tax Certification
UST-19
Certification of Leak Detection Exempt for Suction Piping Associated with USTs
UST-20
Alternative Fuel Compatability Checklist
UST-21
Impressesd Current Cathodic Protection System 60-Day Record of Rectifier Operation
UST-22A
Annual Overfill Prevention Operability Check
UST-22B
Annual Interstitial Sensor Operability Check
UST-22C
Annual Containment Sump Visual Inspections
UST-23A
Triennial UST Spill Bucket Integrity Testing
UST-23B
Triennial UST Containment Sump/UDC Integrity Testing
UST-23C
Triennial UST Piping Integrity Testing
UST-23D
Triennial UST Intertice Integrity Testing
State Cleanup Funds
Eligibility Forms
Changes effective 3/1/08 Memo
Memo Eligibility Application Form 01/09
Eligibility Application Form (rev 01/09)
Extra Tank Data Worksheet
Extra Corrosion Protection & Spill Overflow worksheet
Financial Responsibility
Chief Financial Officer Letter
Certificate of Insurance (UST-FR1)
Certification of Financial Responsibility
Federal Cleanup Funds
Financial Data Request Form
Reasonable Rate Documents
1998 and 2003 Reasonable Rates
Directed Pre-approval Task Authorization Form
nonDirected Pre-appoval Authorization Form
400 W. Market Str
eet, Suite 300,
Greensboro, NC 27401 | t :336
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641
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777 | f : 336
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641
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3730