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Department of Safety and Professional Services
Announcement of Creation of DSPS by Secretary Dave Ross
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Environmental and Regulatory Services

PECFA and Storage Tanks:
201 W. Washington Ave.
Madison, WI 53703


Media Contact Only:
Greg Gasper
(608) 266-6795
Greg.Gasper@wi.gov

Office of Governor
Scott Walker
Link to Governor Walkers's web site

 
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Storage Tank Regulation - Comm 10 Forms

The following list reflects Comm 10 Forms used by the Department relating to the UST/AST program.

NOTE ON PRINTING: The pdf are converted to .pdf format to improve web compatibility. When printing the forms, use the print icon associated with the embedded pdf page, not the print icon on the browser tool bar. The icon for the pdf embedded page generally appears near the left side of the screen just above the document display.
If you need a reader to access pdf in pdf format, click here to download the Adobe Acrobat reader.

INTERACTIVE FORMS - Forms that you can fill in on your computer.
We are beginning to modify the Comm 10 forms, giving you the capability to fill in the form using your computer. Note: No computation, verification or electronic submittal of the information you enter is being provided at this time. You cannot save this file, you only have the ability to print it out. If you wish to save this file, other purchased software is available commercially. Forms with the (IaFm) designation in the following table identify those forms with computer fill-in capability. The speed and configuration of your individual PC will determine how rapid and responsive the program is to the input of information. Forms that are acceptable for electronic communication will be evident by the green "send" button on the form. Because some forms are pdf that require an original signature, they will not be provided with electronic mailing capability.

Steps to completing Interactive Forms (IaFm)
If not already on your computer, please download the free 3.0 Adobe Reader below, before preceding with step two.

  1. Use Adobe Reader to open the file (your browser may be configured to open the file automatically upon download).
  2. You must click on the Icon with the "hand" to activate the mechanism that will allow you to fill in the information on-line.
  3. Navigate through the form using the tab key or by placing your mouse cursor in the appropriate area you wish to fill in. Tab key navigation does not always follow the sequence that you expect. You may want to enlarge the form for better navigation and cursor accuracy. You must use your pointer to fill in check boxes, you can not tab from one check box to another. The cursor will change to an arrow for filling in check boxes.
  4. When done filling in the information of the form , tab out of the last area in which you entered information, and select the print option on the Adobe toolbar at the top of the form. Do not use the print icon on the browser tool bar.
  5. You do not have to access the Internet or activate your browser every time you want to use the form. After initially downloading the form and saving it to a file, you can access the form through Adobe Exchange which you should have already placed on your computer.

Name of Form

Form Number

Last Revision Date


I  Tank Registration:

Underground Flammable/Combustible Liquid Storage Tank Registration (IaFm)

ERS-7437
3/2011
Aboveground Flammable/Combustible Liquid Storage Tank Registration (IaFm)
ERS-8731
3/2011

II Tank or Related Component Installation / Closure:

Flammable Liquid Tanks Installation Application (IaFm)

ERS-9 3/2011

Alternative Fuels Conversion /Installation Application (IaFm)   (Ethanol & Biodiesel)

ERS-9 Alt Fuels
2/2007
Point-of-Sale Fueling Installation (IaFm)
ERS-6294 POS
9/ 2004
Leak Detection Installation, Conversion or Upgrade (IaFm) ERS-9 LD 3/2011
Farm & Construction AST Installation Application
ERS-10764
10/2004
Contractor - Comm 10 Notification (IaFm)
ERS-9198
2/2008
Pre-construction Meeting
ERS-6294 PCM
9/ 2004
Checklist for Underground Tank Installation
ERS-6294
3/2011
Checklist for Aboveground Tank Installation
ERS-9658
3/2011
Checklist and Report for Tank Closure (TSSA)                                  Part A and B
ERS-8951
1/2010
                                                                                                   Part A Only

                                                                                                   Part B Only


III Inspection
and Testing (Regulatory inspector, Contractor)
UST Corrosion Protection Test Summary
ERS-10785
1/2011
Annual Underground Tank System Functionality Verification
ERS-10778
1/2011
Annual Underground Tank System Functionality Verification GUIDE
1/2011
API 653 Tank Inspection Summary Report
ERS-10737
1/ 2002
Line Leak Detector Functionality Test Report  ERS-10778 LLD 2/2012
Tank System Repair Report   (For repairs associated with releases to the environment) ERS-10901 3/2011
Annual / Periodic Line Test ERS-10778 LT 2/2012

IV Inspection
(Owner or Operator)


PEI 900 UST System Inspection Schedule Summary

Daily UST System Inspection  (PEI 900 Form)

Monthly UST System Inspection  (PEI 900 Form)

Annual UST System Inspection  (PEI 900 Form)

STI SP001 AST Monthly Inspection (Commerce modified form) ERS-10897-STI 7/2010
STI SP001 AST Annual Inspection  (Commerce modified form) ERS- 10898-STI 7/2010
    AST Data Record as Companion to STI SP001 inspection forms
7/2010

V  Financial Responsibility -- Certification of Financial Responsibility:
Pollution Insurance:  a) Owner/Operator    b) Owner is not the Operator

 
Self-insurance

 
Government Bond

 

VI  Operator Training
Facility Level C Operator Responsibility Checklist  (IaFm) 7/2011
Facility Operator Level A and/or B Designation  (IaFm) 7/2011

VII Other:
Wisconsin Material Approval Application
ERS-8028A
2/2005
Petition for Variance Application (IaFm)
ERS-9890A
11/ 2010
Continuing Education Course Application (IaFm)
ERS-9156
2/2001
Red Tag Example
ERS-8980
1/ 1998
Code or Statute Change Proposal (IaFm)
ERS-10503-A
1/2008
STI SP031 Repair / Modification Summary ERS-10873 3/2008
Important Building Determination
05/2011