The Removal Application Form is the Sacramento County Environmental Management Department (SCEMD) application for the authority to remove underground storage tanks (USTs); the form is printed as the Consolidated Application for a Permit to Remove Underground Storage Tanks. Tank owners and their removal contractors use it before any UST construction activity begins, and the department answers with an "Authority to Remove UST" letter. On this page you can fill out the form online on FillingPDF and download or print the completed PDF. The original is published by the department at the official URL.
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What is Removal Application Form – Sacramento County, CA?
The Removal Application Form, printed as the Consolidated Application for a Permit to Remove Underground Storage Tanks, is the Sacramento County Environmental Management Department (SCEMD) form a tank owner uses to request authority to remove underground storage tanks (USTs) or piping.
Completing it starts the permit step for a removal. SCEMD responds with an "Authority to Remove" letter, which the form calls the permit. The letter is addressed to the owner, names the contractor, and lists inspection scheduling and site-specific construction requirements. No UST construction activity can proceed before it is issued.
The form has four working parts: the owner, facility and contractor block on page 1; Section I. REQUIRED INFORMATION (tanks and piping or piping only, tank size, product stored, and where the tanks and rinsate go); Section II: SOIL SAMPLING PROTOCOL (who samples the soil and which laboratory analyzes it); and Section III. REQUIREMENTS AND LIMITATIONS, a list of 14 rules the owner agrees to follow by signing. The final page is a field inspector's record that SCEMD completes.
On its UST forms page, SCEMD lists this form with related documents such as the UST Application Form, the Legal UST Owner's Authorization Letter, the Application to Temporarily Close Underground, and the Sampling Protocol for UST Removals, Upgrades, and Repairs. Each is a separate document.
Who needs to file Removal Application Form – Sacramento County, CA?
The tank owner files this application when underground storage tanks, or only their piping, are to be removed. The owner signs the application. The form also names the removal contractor (with license number and expiration date), who signs and dates the contractor line on page 1.
Other roles the form assigns:
- Soil sampling: the owner or the owner's agent must contract an independent qualified third party to collect soil samples, and a State approved analytical laboratory to analyze them.
- Someone signing for the owner: a copy of an authorized signatories form must be on file with the department if an individual signs for the tank owner. SCEMD's forms page also lists a Legal UST Owner's Authorization Letter, used when the application is not filled out by the owner.
- Hazardous waste details: the application asks for the hazardous waste transporter EPA number and the generator number for the rinsate or tanks.
The form says nothing about owners who are not removing tanks. Other UST situations, such as temporary closure, use separate forms listed on SCEMD's page.
When to file Removal Application Form – Sacramento County, CA
File the application before any tank removal work, because no UST construction activity can proceed until the department issues the "Authority to Remove" letter. The form says to allow at least fourteen (14) days for that letter, and more time if parts of the application are incomplete or incorrect.
The application expires six months from the date of submittal. An SCEMD representative must be present during the tank removal and sampling, so set the inspection appointment at least three working days (72 hours) before the removal.
After sampling, the soil sample analyses, quality control data, sampling plot map and chain of custody must reach the department within 30 days. Section II asks you to estimate the date the results will be submitted.
Documents you need
- A copy of an authorized signatories form, kept on file with the department, if an individual signs for the tank owner.
- Legal UST Owner's Authorization Letter, which SCEMD's forms page says is used when the application is not filled out by the owner.
- A written proposal for on-site tank cutting, sent to SCEMD and the local fire protection district before any cutting, only if you seek an exception to the cutting prohibition.
- After removal: rinsate manifest, unless SCEMD waived the rinsing requirement, and the tank disposal certificate.
- After removal: a site map to scale with sample locations and identification, and documentation of stockpile quantity and disposition.
- After removal: complete analytical results with chain-of-custody and laboratory quality assurance and control sheets; preliminary results are not acceptable.
- After removal: Hazardous Waste Tank Closure Certification, only if the tank is not going to be disposed of as hazardous waste.
How to fill out Removal Application Form – Sacramento County, CA
Enter owner and facility details
On page 1, enter the owner's name, phone, address, city and ZIP. Then enter the facility name, phone, address, city and ZIP, plus the nearest cross street, fire district and assessor's parcel number.
Enter the contractor information
Fill in the contractor's name, phone, address, city and ZIP, and the contractor's license number and its expiration date.
Sign the contractor line
The contractor signs and dates the CONTRACTOR SIGNATURE and DATE line on page 1.
Add hazardous waste identifiers
Enter the hazardous waste transporter EPA number and the hazardous waste generator number for the rinsate or tanks.
Complete Section I
Check Tanks & Piping or Piping Only. Then enter the size of the tank(s), the product stored, the destination of the tank(s) after removal and the destination of the rinsate.
Identify sampler and laboratory
In Section II, give the name, address and phone number of the person or company that will take soil samples. Do the same for the analytical laboratory, and estimate the date the results will be submitted.
Read the Section III requirements
Go through the 14 requirements on pages 3 to 5, including fire extinguishers, no smoking, triple rinsing, dry ice purging, the 10% LEL and O2 limit, and the ban on on-site cutting. By signing, you state that you will adhere to them.
Complete the owner's signature block
The tank owner signs and enters the printed name, title, date and phone number. If an individual signs for the owner, make sure an authorized signatories form is on file with the department.
Leave agency-use areas blank
Do not write in the FOR AGENCY USE ONLY box on page 1 or the field inspector record on page 6; the department completes them.
Review and download the completed PDF
Check names, addresses, license number and dates, then download or print the completed PDF from FillingPDF. Prepare the permit fee and submit as described under How to submit.
How to submit Removal Application Form – Sacramento County, CA
The form names no mailing, online or in-person channel. It prints the department's contact details instead: Environmental Management Department, 11080 White Rock Road, Ste. 200, Rancho Cordova, CA 95670; Tel (916) 875-8550; Fax (916) 875-8513. Call the department to confirm how it wants the application delivered.
- Fee: the permit fee is submitted with the application. The form refers you to the fee schedule for the amount; ask the department at the number above for the current figure.
- Signatures: the owner's signature block and the contractor's signature must be completed. If an individual signs for the tank owner, a copy of an authorized signatories form must be on file with the department.
- Inspection appointment: schedule it with the department at least three working days (72 hours) before removal.
- After removal: send the post-removal documents listed under Section III, item 14, to SCEMD. If no contamination problem exists, SCEMD issues a "Removal Completion" letter.
FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Starting any UST construction activity before the department issues the "Authority to Remove" letter.
- Scheduling the removal without setting an inspection appointment at least three working days (72 hours) in advance.
- Submitting the application without the permit fee, which the form says is submitted with it.
- Having an individual sign for the tank owner without an authorized signatories form on file with the department.
- Sending preliminary laboratory results after removal; the form accepts only complete analytical results.
- Delivering soil sample analyses, quality control data, plot map and chain of custody later than 30 days after sampling.
- Cutting tanks on site, or hot cutting, without advance approval from SCEMD and the local fire protection district; hot cutting is never allowed.
- Leaving Section I unmarked, so it is unclear whether the work covers tanks and piping or piping only.
- Expecting the application to remain valid past six months from the date of submittal.
Frequently asked questions
What is the Sacramento County Removal Application Form?
It is the Environmental Management Department's application for the authority to remove underground storage tanks, printed as the Consolidated Application for a Permit to Remove Underground Storage Tanks. The department answers with an "Authority to Remove" letter, which the form calls the permit.
Is this the Sacramento County business license form?
No. This form is the application for authority to remove underground storage tanks or piping, issued by the Sacramento County Environmental Management Department. It asks for owner, facility, contractor, tank and soil sampling details, and it is not a business license application.
How long does it take to get the Authority to Remove letter?
Allow at least fourteen (14) days. The form says to allow more time if parts of the application are incomplete or incorrect, so check every section before you submit.
Is there a fee for the removal permit?
Yes. The form says the permit fee is submitted with the application and refers you to the fee schedule for the amount. Call the department at (916) 875-8550 for the current figure.
How far ahead must I schedule the tank removal inspection?
At least three working days (72 hours) before the tank removal. An SCEMD representative must be present during the removal and sampling, and the inspection appointment must be set with the department in advance.
How long is the application valid?
The form states the application expires six months from the date of submittal. Plan the removal within that window, and remember that no UST construction activity can proceed before the Authority to Remove letter is issued.
Who signs the Removal Application Form?
The tank owner signs the owner's block, and the contractor signs the contractor line on page 1. If an individual signs for the tank owner, a copy of an authorized signatories form must be on file with the department.
What do I send to the county after the tanks are removed?
Section III, item 14 lists the rinsate manifest, tank disposal certificate, scaled site map, complete analytical results, stockpile documentation and, if applicable, the Hazardous Waste Tank Closure Certification. If no contamination problem exists, SCEMD issues a "Removal Completion" letter.
Can I fill out the removal application online on FillingPDF?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file the application or pay the fee; you submit it through the department's own channels.
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