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Aboveground Storage Inventory Form

Aboveground Storage Inventory Form

Aboveground Storage Inventory Form

This form is to be used for the registration of Regulated Substances stored aboveground in tanks, drums, and other storage units. This form must be submitted with the General Facility Data form.
  • ABOVEGROUND REGULATED SUBSTANCE STORAGE INVENTORY

    This form is to be used for the registration of Regulated Substances stored aboveground in tanks, drums, and other storage units. This form must be submitted with the General Facility Data form.
  • I. Regulated Substance Inventory

    List those substances subject to regulation under the Source Water Protection Program in the table on the back of this form.
  • II. Total Quantity

    Regulated Substance quantities may be reported, at the choice of the facility operator, as the maximum amount stored on site at any one time or as a monthly daily average. The maximum amount is the maximum quantity of Regulated Substances found on site at any time during the course of the year. The maximum amount may be used to report Regulated Substance use if you consistently store greater than 55 gallons of Regulated Substances on site in the 1 and 5 year TOT, or 1,000 gallons or more of Regulated Substances on site in the 10 year TOT. The monthly daily average is the daily average quantity of Regulated Substances stored or otherwise used on site over the course of a 30 day month. The monthly daily average may be used if you consistently store Regulated Substances in quantities close to the quantity thresholds specified above. To calculate the monthly daily average, track the total quantity of Regulated Substance stored on site over the course of a month, including all deliveries, and divide that total by 30. A work sheet is available to help with this approach. Either calculation should be based on peak times if there are seasonal fluctuations in Regulated Substance use. For more information on these methods of calculating quantity, please contact the Groundwater Consortium Manager at (513) 383-3162.
  • gal.
  • lbs.
  • II. Certification

    I hereby certify that I have reviewed this document and, to the best of my knowledge and belief, the information in this document is true, complete, and accurate based on data available to the owner or operator or contact person for this facility.
  • print name/title
  • No. of UnitsUnit Size and Type (lbs,gal.)Unit MaterialConcentration (%)On An Impervious Surface? (Yes/No) *1Secondary Containment? *2General Location (indoors/outdoors)Requires a Spill Control Plan? (Yes/No) *3 
    Add a new row
    1. An impervious surface includes a concrete floor or cement surface area. 2. Secondary containment includes dikes, double walled tanks, or other containment devices. 3. A Spill Control Plan (SCP) is required under the SWPP only for regulated substance(s) stored in an area where a release could reach a pervious ground surface, dry well, storm sewer, septic system, or surface water body. If your facility does not have a pre-existing SCP for storage units meeting this release condition, a SWPP SCP must be developed. A template is available for your use. A SWPP SCP is not required for regulated substances stored with secondary containment.
  • (optional)

Fairfield General Facility Registration Form


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Signature Certificate
Document name: Fairfield General Facility Registration Form
lock iconUnique Document ID: e0759c7ec58795a1b7257d754cb818da59e4f39c
Timestamp Audit
September 1, 2022 11:17 am ESTFairfield General Facility Registration Form Uploaded by Tim McLelland - tim.mclelland@hamilton-oh.gov IP 216.48.130.130

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