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E��lvFA01EtTlON 0.e ,.s_ Florida Department of Environmental Protection Twin Towers Office Bldg.0 2600 Blair Stone Road 0 Tallahassee,Florida 32399.2400 zs FLOR A Division of Waste Management-Storage Tank Facility Registration Form ° • Registration Instructions and Codes List The Department of Environmental Protection Storage Tank Program registers the facilities and the storage tanks when aboveground or underground storage tanks store pollutants, hazardous substances, and/or mineral acid substances regulated by Chapter 62-761, Florida Administrative Code,or when aboveground storage tanks or compression vessels store a hazardous substance which requires registration according to Chapter 376,Florida Statutes. Storage Tank Facility Registration Form In the first section block,identify the types of information being submitted on the registration form. Check New Registration when the location is being registered for the first time and no Facility Identification number exists. If submitting a revised Registration form,check all other boxes that apply to designate the type(s)of revisions being submitted. I. Facility Information-Properly describe the geographical location where the storage tank facility is located. Facility ID Include the DEP Facility Identification number whenever possible. Write in"Pending"when submitting a new registration for the first time. Remember: the facility ID number identifies the location, and is transferred to a new owner upon sale of the facility. Facility Name Provide the current name of the business establishment operating at the facility location. When registering an abandoned facility, where tanks exist unmaintained, identify the location with the property owner's name,as in"Smith Property", if no other facility name is being used. Facility Address Include the county name,and the proper street number and name. Give directions when the facility is located in a rural area with no Rural Route number associated with it (i.e.,`x'miles N of intersection...). Provide the name and telephone number of a contact person or manager on location,where possible. Facility Type This information is an explanation or term that most closely describes the operational use of the facility. Select the code(s) that provides the best or most appropriate description of the facility. 1. If the facility is owned by a government entity,select the appropriate type from the following: F. Federal Government H. Local or City Government N. Indian Land G. State Government I. County Government 2. If the facility meets the definition of"bulk product facility" -"a waterfront location with at least one aboveground tank with a capacity greater than 30,000 gallons which is used for the storage of pollutants" ("Pollutants" includes oil of any kind and in any form,gasoline, pesticides,ammonia,chlorine,and derivatives thereof,excluding liquefied petroleum gas.");select the type from: T. Coastal bulk product facility - facility, as defined above and located on the Florida coast, may have storage tank systems that store hazardous substances in addition to pollutants. ("Coastline means the line of mean low water along the portion of the coast that is in direct contact with the open sea and the line marking the seaward limit of inland waters, as determined under the Convention on Territorial Seas and the Contiguous Zone, 15 U.S.T.(Pt.2) 1606."). S. Inland Waterfront bulk product facility-facility,as defined above and located on"inland waterways"(lakes,rivers),may have storage tank systems that store hazardous substances in addition to pollutants. 3. When the facility is a"waterfront location",but not a bulk product facility as defined above,select the most appropriate type from: V. Marine fueling facility-a commercial,recreational, or retail coastal facility that provides fuel to vessels and may store other pollutants and/or hazardous substances on site. W. Waterfront fueling facility-a commercial,recreational,or retail facility located on a non-coastal waterway that provides fuel to vessels and may store other pollutants and/or hazardous substances on site. 5/1/00 l Storage Tank Registration Instructions