State of Wisconsin

Department of Agriculture, Trade and Consumer Protection

Petroleum / Hazardous Liquids Storage Tanks Forms

I — Tank Registration & Permitting:	DATCP Form Number
Underground Flammable/Combustible Liquid Storage Tank Registration Word Version / PDF Version	TR-WM-137
Aboveground Flammable/Combustible Liquid Storage Tank Registration Word Version / PDF Version	TR-WM-118
Storage Tank Change of Ownership Word Version / PDF Version	TR-WM-153
Storage Tank Permit Application Please call us at 608-224-4942, option 3 to request your site-specific pre-populated application form.	TR-WM-160

II — Tank or Related Component Installation / Closure:		DATCP Form Number
Flammable Liquid Tanks Installation Application Word Version / PDF Version		TR-WM-126
Wisconsin Telecommunication Tower Generator Fuel Supply Tank Aboveground Installation Application Word Version / PDF Version		TR-WM-143
Alternative Fuels Conversion / Installation Application (ethanol & biodiesel) Word Version / PDF Version		TR-WM-132
Point-of-Sale Fueling Installation Word Version / PDF Version		TR-WM-130
Leak Detection Installation, Conversion or Upgrade Word Version / PDF Version		TR-WM-133
Contractor - ATCP 93 Notification Word Version / PDF Version		TR-WM-121
Pre-construction Meeting Word Version / PDF Version		TR-WM-131
Checklist for Underground Tank Installation Word Version / PDF Version		TR-WM-138
Checklist for Aboveground Tank Installation Word Version / PDF Version		TR-WM-120
Pre-Operational Tank Tightness Test Word Version / PDF Version		TR-WM-155
Checklist and Report for Tank Closure (TSSA) (Parts A and B) Word Version / PDF Version		TR-WM-140
DNR Stage II Vapor Recovery Decommissioning Notification		TR-WM-122
Stage II Decommissioning Questions and Answers
Decommissioning Form
DNR Stage II Vapor Recovery Rule Changes for Gasoline Dispensing Facilities Fact Sheet

III — Inspection and Testing (Regulatory Inspector, Contractor)		DATCP Form Number
UST Corrosion Protection Test/Survey Report Word Version /PDF Version		TR-WM-141
Annual Underground Tank System Functionality Verification Word Version / PDF version		TR-WM-139
Annual Underground Tank System Functionality Verification Guide
API 653 Tank Inspection Summary Report Word Version / PDF Version		TR-WM-119
Line Leak Detector Functionality Test Report Word Version / PDF Version		TR-WM-123
Tank System Repair Report Word Version / PDF Version		TR-WM-136
Tank Precision Tightness Test Report Word Version / PDF Version		TR-WM-152
Line Precision Tightness Test Report Word Version / PDF Version		TR-WM-125

IV — Inspection (Owner or Operator)		DATCP Form Number
Maintenance of Motor Fuel Dispensing Equipment:
Daily Conventional Dispensing Equipment Inspection (PEI 500 Form)
Monthly Dispensing Equipment Inspection (PEI 500 Form)
Annual Dispensing Equipment Inspection (PEI 500 Form)
Daily Vacuum Assist Vapor Recovery System
Post-Incident Fueling System Inspection Checklist
Maintenance of UST Systems:
Daily UST System Inspection Checklist (PEI 900)
Monthly UST System Inspection Checklist (PEI 900)
Annual UST System Inspection Checklist (PEI 900)
Maintenance of AST Systems:
STI SP001 Monthly Tank Inspection Checklist Word Version / PDF Version		TR-WM-128
STI SP001 AST Annual Inspection Word Version / PDF Version		TR-WM-135
AST Data Record as Companion to STI SP001 Inspection Forms

V — Financial Responsibility -- Affidavit of Financial Responsibility:
Pollution Insurance:
Owner is Operator
Self-Insurance
Government Bond

VI — Operator Training:
Facility Level C Operator Responsibility Checklist
Facility Operator Level A and/or B Designation

VII — Other:		DATCP Form Number
Wisconsin Material Approval Application Word Version / PDF Version		TR-WM-127
Petition for Variance Application Word Version / PDF Version		TR-WM-129
Educational Course Approval Application Word Version / PDF Version		TR-WM-107
A/B/C Operator Training Program Approval Application Word Version / PDF Version		TR-WM-159
STI SP031 Repair / Modification Summary Word Version / PDF Version		TR-WM-134
Important Building Determination Word Version / PDF Version		TR-WM-144
Application For Use of An Alternative Method or Equipment Word Version / PDF Version		TR-WM-157