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United States

OMB Control No.2050-0068

Environmental Protection Agency

Approval Expires 08/31/19

Washington, DC 20460

Notification for Underground Storage Tanks

Implementing Agency Name And Address:

IMPLEMENTING AGENCY USE ONLY

ID NUMBER:

DATE RECEIVED:

TYPE OF NOTIFICATION

DATE ENTERED INTO COMPUTER:

 A. NEW FACILITY

 B. AMENDED

 C. CLOSURE OR

DATA ENTRY CLERK INITIALS:

OR ONE-TIME

CHANGE-IN-

NOTIFICATION

SERVICE

OWNER WAS CONTACTED TO CLARIFY RESPONSES, COMMENTS:

(previously deferred

system)

_____

Number of tanks at facility

What USTs Are Included? An UST system is defined as any one or

_____

Number of continuation sheets attached

combination of tanks that is used to contain an accumulation of regulated

substances, and whose volume (including connected underground piping) is 10

INSTRUCTIONS AND GENERAL INFORMATION

percent or more beneath the ground. Regulated USTs store petroleum or

hazardous substances (see What Substances Are Covered below). This

Please type or print in ink. Also, be sure you have signatures in ink

includes UST systems with field-constructed tanks and airport hydrant fuel

distribution systems.

for sections VIII and XI. Complete a notification form for each location

containing underground storage tanks. If more than 5 tanks are

What Tanks Are Excluded From Notification (see § 280.10 and § 280.12)?

owned at this location, you may photocopy pages 3 through 6 and use

• Tanks removed from the ground before May 8, 1986;

them for additional tanks.

• Farm or residential tanks of 1,100 gallons or less capacity storing motor fuel for

The primary purpose of this notification form is to provide information

noncommercial purposes;

• Tanks storing heating oil for use on the premises where stored;

about the installation, existence, changes to, and closure of

•

Septic tanks;

underground storage tank systems (USTs) that store or have stored

• Certain pipeline facilities regulated under chapters 601 and 603 of Title 49;

petroleum or hazardous substances. The information you provide will

• Surface impoundments, pits, ponds, or lagoons;

be based on reasonably available records, or in the absence of such

• Storm water or wastewater collection systems;

records, your knowledge or recollection.

•

Flow-through process tanks;

Federal law requires UST owners to use this notification form for

• Liquid traps or associated gathering lines directly related to oil or gas production

and gathering operations;

all USTs storing regulated substances that are brought into use

• Tanks on or above the floor of underground areas, such as basements or tunnels;

after May 8, 1986, or USTs in the ground as of May 8, 1986 that

• Tanks with a capacity of 110 gallons or less;

have stored regulated substances at any time since January 1,

• Wastewater treatment tank systems;

1974. The information requested is required by Section 9002 of

• UST systems containing radioactive material that are regulated under the Atomic

the Solid Waste Disposal Act (SWDA), as amended.

Energy Act of 1954;

•UST systems that are part of an emergency generator system at nuclear power

	Who Must Notify? 40 CFR part 280, as amended, requires owners	generation facilities regulated by the Nuclear Regulatory Commission under 10
		CFR part 50.
	of USTs that store regulated substances (unless exempted) to notify	CFR part 50.

	implementing agencies of the existence of their USTs. Owner is	What Substances Are Covered? The notification requirements apply to
	defined as:	USTs containing petroleum or certain hazardous substances. Petroleum
	•	includes gasoline, used oil, diesel fuel, crude oil or any fraction thereof which is
	In the case of an UST in use on November 8, 1984, or brought into use	liquid at standard conditions of temperature and pressure (60 degrees
	after that date, any person who owns an UST used for storage, use, or
		Fahrenheit and 14.7 pounds per square inch absolute). Hazardous
	dispensing of regulated substances; or
	•	substances are those found in Section 101 (14) of the Comprehensive
	In the case of an UST in use before November 8, 1984, but no longer in	Environmental Response, Compensation and Liability Act of 1980, with the
	use on that date, any person who owned the UST immediately before its	exception of those substances regulated as hazardous waste under Subtitle C
	discontinuation.
	discontinuation.	of the Resource Conservation and Recovery Act.
		of the Resource Conservation and Recovery Act.
	Also, owners of previously deferred UST systems with field-	When And Who To Notify? Owners who bring USTs into use after May 8,
	constructed tanks and airport hydrant fuel distribution systems in the
		1986 must submit this notification form to the implementing agency within 30
	ground as of October 13, 2015 must submit a one-time notification of
		days of bringing the UST into use. If the implementing agency requires
	existence by October 13, 2018. Owners of UST systems with field-
		notification of any amendments to the facility, send information to the
	constructed tanks and airport hydrant fuel distribution systems
		implementing agency immediately.
	brought into use after October 13, 2015 are considered new facilities	implementing agency immediately.

	and must follow the same notification requirements as all other UST	Penalties: Any owner who knowingly fails to notify or submits false
	owners.	information shall be subject to a civil penalty not to exceed $16,000 for each

		tank for which notification is not given or for which false information is given.

	I. OWNERSHIP OF USTs				II. LOCATION OF USTs
Owner Name (Corporation, Individual, Public Agency, Or Other Entity)				If required by implementing agency, give the geographic location of USTs either in decimal
				degrees, or degrees, minutes, and seconds. Example: Latitude: 36.123480 (or 36° 7'
				24.4"),	Longitude: -106.549876 (or -106° 32' 59.6")
					Latitude ________________ Longitude ________________
Street Address				Facility Name Or Company Site Identifier, As Applicable
County
County				 If address is the same as in Section I, check the box and proceed to section III.

				If address is different, enter address below:
				Street Address
City		State	Zip Code
				County
Phone Number (Include Area Code)				City		State	Zip Code

EPA Form 7530-1 (Rev. 6-2015) Electronic and paper versions acceptable.	Page 1 of 6
Previous editions may be used while supplies last.

United States	OMB Control No.2050-0068
Environmental Protection Agency	Approval Expires 08/31/19
Washington, DC 20460

Notification For Underground Storage Tanks

III. TYPE OF OWNER

IV. INDIAN COUNTRY

Federal Government

State Government

Commercial



Tribal Government

Local Government

Private

USTs are located on land within an	
Indian reservation or on trust lands	
outside reservation boundaries

Federally recognized tribe where USTs are located:

V. TYPE OF FACILITY



Auto Dealership

Commercial Airport Or Airline

Contractor

Farm

Federal – Non-military



Federal – Military

Gas Station

Industrial

Petroleum Distributor

Railroad



Residential

Trucking Or Transport

Utilities

Other (Explain) ____________________

VI. CONTACT PERSON IN CHARGE OF TANKS

Name:

Job Title:

Address:

Phone Number (Include Area Code):

VII. FINANCIAL RESPONSIBILITY

I have met the financial responsibility requirements (in accordance with 40 CFR part 280 Subpart H) by using the following mechanisms: (check all that apply)

 Bond Rating Test	 Local Government Financial Test	 Surety Bond
 Commercial Insurance	 Risk Retention Group	 Trust Fund
 Guarantee	 Self-insurance (Financial Test)	 Other Method (describe here)
 Letter Of Credit	 State Fund	___________________________

I do not have to meet financial responsibility requirements because 40 CFR part 280 Subpart H is not applicable to me (e.g., if you are a state or federal owner).

VIII. CERTIFICATION (Read and sign after completing ALL SECTIONS of this notification form)

I certify under penalty of law that I have personally examined and am familiar with the information submitted in Sections I through XI of this notification form and all attached documents, and that based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the submitted information is true, accurate, and complete.

Name and official title of owner or owner’s	Signature	Date Signed
authorized representative (Print)

Paperwork Reduction Act Notice

The public reporting and recordkeeping burden for this collection of information is estimated to average 30 minutes per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

EPA Form 7530-1 (Rev. 6-2015) Electronic and paper versions acceptable.	Page 2 of 6
Previous editions may be used while supplies last.

United States	OMB Control No.2050-0068
Environmental Protection Agency	Approval Expires 08/31/19
Washington, DC 20460

Notification For Underground Storage Tanks

IX. DESCRIPTION OF UNDERGROUND STORAGE TANKS (Complete for all tanks and piping at this location)

Tank Identification Number	Tank No.	Tank No.	Tank No.	Tank No.	Tank No.

1. Status Of Tank (check only one)					
Currently In Use					
Temporarily Closed					
Permanently Closed					

2. Date Of Installation (month/year)

3. Estimated Total Capacity (gallons)

4. Tank Attributes
(check all that apply)
Asphalt Coated Or Bare Steel					
Cathodically Protected Steel					
(impressed current)					
(impressed current)
Cathodically Protected Steel					
(sacrificial anodes)					
(sacrificial anodes)
Coated and Cathodically Protected Steel					
(impressed current)					
(impressed current)
Coated and Cathodically Protected Steel					
(sacrificial anodes)					
(sacrificial anodes)
Composite					
(steel clad with noncorrodible material)					
(steel clad with noncorrodible material)
Concrete					
Fiberglass Reinforced Plastic					
Noncorrodible Tank Jacket					
Lined Interior					
Excavation Liner					
Double Walled					
Manifolded					
Compartmentalized					
Field-constructed					
Unknown					
Other, Specify Here	___________	___________	___________	___________	___________
	___________	___________	___________	___________	___________
Check Box If Tank Has Ever Been					
Repaired					
Repaired
5. Overfill Protection Installed
(check all that apply)
Automatic Shutoff					
Flow Restrictor					
High-level Alarm					
Other, Specify Here	___________	___________	___________	___________	___________

6. Spill Prevention Installed					
Double Walled					

EPA Form 7530-1 (Rev. 6-2015) Electronic and paper versions acceptable.	Page 3 of 6
Previous editions may be used while supplies last.

	United States	OMB Control No.2050-0068
	Environmental Protection Agency	OMB Control No.2050-0068
	Environmental Protection Agency	Approval Expires 08/31/19
	Washington, DC 20460	Approval Expires 08/31/19
	Washington, DC 20460

	Notification For Underground Storage Tanks

Tank Identification Number

Tank No.

7. Piping Attributes
(check all that apply)
Bare Steel					
Galvanized Steel					
Fiberglass Reinforced Plastic					
Flexible Plastic					
Copper					
Cathodically Protected					
(impressed current)					
(impressed current)
Cathodically Protected					
(sacrificial anodes)					
(sacrificial anodes)
Double Walled					
Secondary Containment					
Airport Hydrant Piping					
Unknown					
Other, Specify Here	___________	___________	___________	___________	___________
	___________	___________	___________	___________	___________
8. Piping Delivery Type
(check all that apply)
Safe Suction (no valve at tank)					
U.S. Suction (valve at tank)					
Pressure					
Gravity Feed					
9. Substance Currently Stored (or last
stored in the case of closed tanks)
(check all that apply)
Gasoline (containing ≤ 10% ethanol)					
Diesel					
Biodiesel					
Kerosene					
Heating Oil					
Used Oil					
Gasoline Containing >10% Ethanol	___________	___________	___________	___________	___________
(specify amount of ethanol)
Diesel Containing >20% Biodiesel	___________	___________	___________	___________	___________
(specify amount of biodiesel)
Other, specify here	___________	___________	___________	___________	___________

Hazardous Substance					
Hazardous Substance
CERCLA Name Or CAS Number	___________	___________	___________	___________	___________

Mixture Of Substances					
Mixture Of Substances
Please Specify Substances Here	___________	___________	___________	___________	___________

EPA Form 7530-1 (Rev. 6-2015) Electronic and paper versions acceptable.	Page 4 of 6
Previous editions may be used while supplies last.

		United States						OMB Control No.2050-0068
	Environmental Protection Agency							Approval Expires 08/31/19
		Washington, DC 20460
	Notification For Underground Storage Tanks
Tank Identification Number	Tank No.		Tank No.		Tank No.		Tank No.		Tank No.
10. Release Detection
(check all that apply)	TANK	PIPE	TANK	PIPE	TANK	PIPE	TANK	PIPE	TANK	PIPE
Manual Tank Gauging									
Tank Tightness Testing									
Inventory Control									
Automatic Tank Gauging										
Vapor Monitoring										
Groundwater Monitoring										
Interstitial Monitoring										
(required for new or replaced										
tanks or piping)
Statistical Inventory Reconciliation										
Automatic Line Leak Detectors										
Line Tightness Testing										
No Release Detection Required										
(such as some types of suction piping)										
Other Method Allowed By ImplementingAgency										
Other, Specify Here	___________		___________		___________		___________		___________
X. CLOSURE OR CHANGE IN SERVICE
1. Closure Or Change In Service
Estimated Date The UST Was Last Used
For Storing Regulated Substances	___________		___________		___________		___________		___________
(month/day/year)
Check Box If This Is A Change In
Service									
(i.e., Change of storage to a non-									
regulated substance)
2. Tank Closure
Estimated Date Tank Closed	___________		___________		___________		___________		___________
(month/day/year)	___________		___________		___________		___________		___________
(check all that apply below)
Tank Removed From Ground									
Tank Closed In Ground									
Tank Filled With Inert Material									
Describe The Inert Fill Material Here	___________		___________		___________		___________		___________
3. Site Assessment
Check Box If The Site Assessment Was									
Completed									
Check Box If Evidence Of A Release									
Was Detected									
Other, Specify Here	___________		___________		___________		___________		___________

EPA Form 7530-1 (Rev. 6-2015) Electronic and paper versions acceptable.	Page 5 of 6
Previous editions may be used while supplies last.

United States	OMB Control No.2050-0068
Environmental Protection Agency	Approval Expires 08/31/19
Washington, DC 20460

Notification For Underground Storage Tanks

Tank Identification Number

Tank No.

XI. CERTIFICATION OF INSTALLATION (Complete For UST Systems Installed After December 22, 1988 And For Airport Hydrant Distribution Systems And Field-Constructed USTs Installed After October 13, 2015)

Installer Of Tank And Piping

(check all that apply)

Installer Certified By Tank And Piping Manufacturers

Installer Certified Or Licensed By The Implementing Agency

Installation Inspected By A Registered Engineer

Installation Inspected And Approved By Implementing Agency

Manufacturer’s Installation Checklists

Have Been Completed

Another Method Allowed By

Implementing Agency

Specify Other Method Here

				
				
				
				
				
				
___________	___________	___________	___________	___________

Signature Of UST Installer Certifying Proper Installation Of UST System
___________________________	___________________________	_________________
Name	Signature	Date
___________________________	___________________________
Position	Company

EPA Form 7530-1 (Rev. 6-2015) Electronic and paper versions acceptable.	Page 6 of 6
Previous editions may be used while supplies last.

Question	Answer
Form Name	Form 7530 1
Form Length	6 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 30 sec
Other names	georgia underground storage tank registration, underground storage tank life expectancy, epa form 7530 1, form 4810

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