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Suspected Release Notification Form

INTRODUCTION

In an effort to facilitate communication between the Owner/Operator, DEQ-PTS, and the DEQ Underground Storage Tank program, this form is available on-line.  The Owner/Operator may download the file in the appropriate format and fill in the unshaded portion.  After contacting the DEQ-PTS by telephone and communicating directly with a DEQ-PTS case manager, the Owner/Operator may submit the completed form electronically to that case manager. Please be aware that an unusual operating condition must be reported within 24 hours.   Once the DEQ-PTS has reviewed the Suspected Release Notification Form, the suspected release will either be closed without any additional information or a suspect release letter will be sent to the owner/operator.  Suspected releases  include erratic behavior of product dispensing equipment, the sudden inventory loss of product from the tank system, the triggering of system alarm sensors, or water/product in the sump/spill buckets or secondary containment, as specified in ARM 17.56.502.  Please note that this form is only meant to be completed for a suspected release.  Once a release is confirmed, the DEQ-PRS must be notified within 24 hours.

Suspected Release Notification Form:
Acrobat (.PDF) Format
MS Word (.Doc) Format

Please be aware that if only the MSWord.Doc Format can be filled electronically.  If you do not have MS Word, the Acrobat.PDF Format may be downloaded and completed manually.  You may fax the form to the DEQ-PRS at (406) 841-5050 after notifying us by telephone at (406) 841-5000.