6101 x3442 • 410-537-3092 (fax) • www.mde.maryland.gov Underground Storage System Removal/Abandonment 30-Day Written Notification Case No: Facility No:__________________ ___________________ (check box if facility was not previously registered) This form shall be used to notify the Department at least 30 days before beginning underground storage tank removal and/or abandonment-in-place. When fully completed, this form may be accepted as an amendment to the Notification for Underground S.
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How to fill out the MD MDE/LMA/COM.039 online
This guide provides clear and detailed instructions on how to complete the MD MDE/LMA/COM.039 form online for underground storage system removal or abandonment. Follow these steps to ensure your submission is accurate and compliant with all necessary requirements.
Follow the steps to fill out the form with accuracy.
- Press the ‘Get Form’ button to access the form and open it in your online editor.
- Begin by entering the case number and facility number in the designated fields at the top of the form.
- Indicate whether the facility was previously registered by checking the appropriate box.
- Select the type of facility by marking the corresponding checkbox, such as Government, Commercial, Farm/Nursery, Residential (non-rental), or Other.
- Specify the type of work being performed by checking all relevant boxes such as Removal, Abandonment in Place, Temporary Closure, Installation, or Upgrade of Existing Tank/Piping.
- Fill in the date the work is scheduled to be performed in the provided space.
- Provide the estimated time that the work will be ready for inspection.
- Complete the insurance information section by indicating the type of insurance coverage you possess and fill in the relevant details including policy number and insurer’s information.
- Fill out the contractor information section with the contractor's name and contact details.
- Enter the facility information, including the company name, facility name, mailing address, and contact information.
- Complete the owner information in the dedicated fields, ensuring to include names and contact numbers.
- For underground storage tank information, complete the sections pertaining to tank type, number, capacity, product material, and construction details.
- Indicate whether there are additional underground storage tanks at the facility by selecting 'Yes' or 'No.'
- In the certification section, ensure the signature, title, and date are added by the UST owner or authorized representative, indicating their acknowledgment of the form's accuracy.
- Review all filled sections for completeness and accuracy before saving your changes, downloading, printing, or sharing the form as needed.
Complete the MD MDE/LMA/COM.039 form online to ensure timely processing of your underground storage tank application.
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