To set up your FPMA 30-Day UST Visual Walkthrough Inspection Form (FPMA 30-Day UST Inspection Form), we will need to obtain the following information. Although some of the information can be obtained through the Florida Department of Environmental Protection (FDEP), we want to ensure the information is as accurate as possible.

Please complete the following form for each of your facilities. If you have more four or more facilities, please feel free to contact Kurt Winters via email at kurt@cstatmobile.com or 817-296-4466 and we can send you an alternative method for providing the information below.

Please provide your contact information.

First Name

Last Name

Phone

(###)

###

####

Email *

Enter the Facility ID

FDEP Facility ID

Facility Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Message

Number of USTs

Enter the 1st Open (in-use) Tank ID

Enter the capacity of the 1st tank (gallons) *

Enter the 2nd Open (in-use) Tank ID

Enter the capacity of the 2nd tank (gallons)

Enter the 3rd Open (in-use) Tank ID

Enter the capacity of the 3rd tank (gallons)

Enter the 4th Open (in-use) Tank ID

Enter the capacity of the 4th tank (gallons)

Enter the 5th Open (in-use) Tank ID

Enter the capacity of the 5th tank (gallons)

Do all the tanks utilize the same tank release detection method?

Tank Release Detection Monitoring Types

Choose each of the tank release monitoring methods used at the facility

Automatic tank gauge (ATG)

Continuous interstitial monitoring (CIM)

Statistical inventory reconciliation (SIR)

Inventory control (IC)

Manual groundwater monitoring (GWM)

Soil vapor monitoring (SVM)

Manual interstitial monitoring for tanks (MIMT)

Do all the product lines utilize the same line release detection method?

Line Leak Detection Method(s) Types

Choose each of the line leak detection methods used at the facility

Continuous interstitial monitoring (CIM)

Monthly piping leak test (MPLT)

Statistical inventory reconciliation (SIR)

Manual groundwater monitoring (GWM)

Soil vapor monitoring (SVM)

Manual interstitial monitoring for piping (MIMP)

Manufacturer of ATG

Model of Veeder-Root ATG

If you have a Veeder-Root ATG, select the model of the ATG

Model of Franklin Fueling ATG

If you have a Franklin Fueling ATG, select the model.

Model of OMNTEC ATG

If you have a OMNTEC ATG, select the model.

Model of OPW ATG

If you have a OPW ATG, select the model.

Enter the contents of the 1st tank

Enter the contents of the 2nd tank

Enter the contents of the 3rd tank

Enter the contents of the 4th tank

Enter the contents of the 5th tank

Thank you!

Download our App

Follow CSTAT on LinkedIn

Main Navigation

Special Pages