UST Forms

For more information, refer to our UST Technical Resources, Manuals and Guidance Documents.

When working on installations, repairs, replacements or upgrades of an underground storage tank system, the Documentation Requirements for UST Systems and Components guide can be used to determine what forms must be submitted to the DNR. Installers can use the UST Installation Paperwork Checklist (542-0075) to assist with paperwork. Some documents are due to the DNR 30 days in advance of work being started.  ALLOW 10 BUSINESS DAYS for processing once all installation paperwork is submitted to the Iowa DNR UST Section.

Additional information may be found in the Installer Guidelines for Installation of UST Systems in Iowa.

• 542-0011 Change in Ownership
  542-0011 Change in Ownership
   
• 542-0016 Stage 1 Vapor Recovery Survey Form
  542-0016 Stage 1 Vapor Recovery Survey Form
   
• 542-0048 Fuel Delivery Authorization Request Form
  542-0048 Fuel Delivery Authorization Request Form
   
• 542-0068 Cathodic Protection (CP) System Form
  542-0068 Cathodic Protection (CP) System Form
   
• 542-0069 Installer Inspection Checklist
  542-0069 Installer Inspection Checklist
   
• 542-0075 UST Installation Paperwork Checklist
  542-0075 UST Installation Paperwork Checklist
   
• 542-0095 UST Inspection Response Form
  542-0095 UST Inspection Response Form
   
• 542-0103 Returning an UST to Service Notification
  542-0103 Returning an UST to Service Notification
   
• 542-0104 Notification of Intent to Install
  542-0104 Notification of Intent to Install
   
• 542-0114 UST Monthly Electronic Interstitial Monitoring
  542-0114 UST Monthly Electronic Interstitial Monitoring
   
• 542-0115 UST Monthly Manual Interstitial Monitoring
  542-0115 UST Monthly Manual Interstitial Monitoring
   
• 542-0153 Secondary Containment Testing Report Form
  542-0153 Secondary Containment Testing Report Form
   
• 542-0154 UST Decommissioning Form
  542-0154 UST Decommissioning Form
   
• 542-0156 Ampere and Voltage Meter Rectifier Readings Form
  542-0156 Ampere and Voltage Meter Rectifier Readings Form
   
• 542-0178 Line Tightness Test Form
  542-0178 Line Tightness Test Form
   
• 542-0274 UST Closure Claim Form
  542-0274 UST Closure Claim Form
  
  
   542-0277 Line Leak Detection with a Mechanical Line Leak Detector
• 542-0277 Line Leak Detection with a Mechanical Line Leak Detector
   
• 542-0278 Line Leak Detection with an Audible or Visual Alarm
  542-0278 Line Leak Detection with an Audible or Visual Alarm
  
  
• 542-0398 30-Day Walk-through Inspection Form
  542-0398 30-Day Walk-through Inspection Form
  
  
• 542-0399 Annual Walk-through Inspection Form
  542-0399 Annual Walk-through Inspection Form
  
  
• 542-0479 Replacement Tank Tag Form
  542-0479 Replacement Tank Tag Form
   
• 542-0510 Equipment Repair / Replacement Form
  542-0510 Equipment Repair / Replacement Form
   
• 542-0986 Affidavit: Exempt Pre 1974 Underground Storage Tanks
  542-0986 Affidavit: Exempt Pre 1974 Underground Storage Tanks

• 542-1300 Site Check
  542-1300 Site Check
   
• 542-1303 UST Closure Report for Filling In Place
  542-1303 UST Closure Report for Filling In Place
   
• 542-1306 UST Closure Report for Tank and Piping Removal
  542-1306 UST Closure Report for Tank and Piping Removal
   
• 542-1308 Notification of Tank Closure or Change-in-Service Form
  542-1308 Notification of Tank Closure or Change-in-Service Form
   
• 542-1310 Release Report Form (Owners/Operators)
  542-1310 Release Report Form (Owners/Operators)
   
• 542-1311 Notification of Temporary Closure Form
  542-1311 Notification of Temporary Closure Form
   
• 542-1327 Notification of Release (UST Professionals)
  542-1327 Notification of Release (UST Professionals)
   
• 542-1336 UST System Checklist for Equipment Compatibility
  542-1336 UST System Checklist for Equipment Compatibility
   
• 542-1337 Ethanol Inspection Form
  542-1337 Ethanol Inspection Form
   
• 542-1422 Manual Tank Gauging Record
  542-1422 Manual Tank Gauging Record
   
• 542-3266 UST Registration Form #148
  542-3266 UST Registration Form #148