Initial Abatement Action (Site Check, UST Closure with UST-2 Form, Excavation, Report Excavation Soil Contamination Assessment) In addition to reporting initial response and abatement actions and assessment actions, and presenting an initial site characterization, when a release has been discovered, this newly-created must fulfill the requirements for the following individual Initial Abatement Action Report reports: (Section E), (Section F), Site Check Report UST Closure Report (UST-12) with UST-2 Form Post-Excavation Soil Contamination (Section J), and (Section G). If needed, check with your regional office to determine Assessment Report Free Product Recovery Report which report format is required. Complete Sections A-N, as required, including the sections specifically designated for the reports you have indicated. The Initial Abatement must be submitted to the appropriate regional office within 90 days following discovery of release. Action Report Site Information Site Identification of Report: Site Risk: Date I.D.: UST Incident Number (if known): Facility Name: Site Address: Street Zip Code: County: City/Town: of Geographical Data Point Description (e.g., diesel fill port): Method (GPS, topographical map, other): Location Longitude (decimal (decimal Latitude degrees): degrees): 2. Information about Contacts Associated with the Leaking UST System (Addresses must include street, city, state, zip code and mailing address, if different) Email: UST/AST Address: Tel: Operator: Email: UST/AST Address: Tel: Owner: Email: Property Address: Tel: Occupant: Email: Property Address: Tel: Email: Consultant/Contractor: Address: Tel: Laboratory: State Certification No: Analytical Address: Tel: 3. Information about the Release Discovered: Date Quantity of Release: Estimated of Release: of Release Source (e.g., Dispenser/Piping/UST): and Contents of Tanks Sizes or Other Containment from which the Release Occurred:
Initial Abatement Action (Site Check, UST Closure with UST-2 Form, Excavation, Soil Contamination Assessment) Report In addition to reporting initial response and abatement actions and assessment actions, and presenting an initial site characterization, when a release has been discovered, this newly-created Initial Abatement Action Report must fulfill the requirements for the following individual reports: Site Check Report (Section E), UST Closure Report (UST-12) with UST-2 Form (Section F), Post-Excavation Soil Contamination Assessment Report (Section J), and Free Product Recovery Report (Section G). If needed, check with your regional office to determine which report format is required. Complete Sections A-N, as required, including the sections specifically designated for the reports you have indicated. The Initial Abatement Action Report must be submitted to the appropriate regional office within 90 days following discovery of release. Site Information Site Identification Date of Report: Site Risk: Facility I.D.: UST Incident Number (if known): Site Name: Street Address: City/Town: Zip Code: County: Description of Geographical Data Point (e.g., diesel fill port): Location Method (GPS, topographical map, other): Latitude (decimal degrees): Longitude (decimal degrees): 2. Information about Contacts Associated with the Leaking UST System (Addresses must include street, city, state, zip code and mailing address, if different) UST/AST Email: Address: Tel: UST/AST Operator: Email: Address: Tel: Property Owner: Email: Address: Tel: Property Occupant: Email: Address: Tel: Consultant/Contractor: Email: Address: Tel: Analytical Laboratory: State Certification No: Address: Tel: 3. Information about the Release Date Discovered: Estimated Quantity of Release: of Release: Source of Release (e.g., Dispenser/Piping/UST): Sizes and Contents of Tanks or Other Containment from which the Release Occurred: Excavation
COMMENT%20DRAFT%20Appendices%20for%20STIRA%20CHANGE%206_20170301.docx