Underground Storage Tank Cleanup Fund (USTCF)
Forms and Publications
OWNERS/OPERATORS OF SINGLE-WALLED USTS
IMPORTANT INFORMATION: Single-walled underground storage tanks (USTs) must be permanently closed by December 31, 2025. This requirement includes both single-walled tanks and nonexempt single-walled piping per California Health and Safety Code, chapter 6.7, section 25292.05. Single-walled UST systems that are not permanently closed by December 31, 2025 will be out of compliance and cannot be operated. Owners and/or operators will be subject to enforcement actions, including affixing red tags and pursuing civil penalties beginning January 1, 2026. For more information, please see the following Single Walled webpage.
Quick Links
Forms
These forms are presented in PDF format.
General Use
- These forms can be submitted via mail, email, or fax
- Claimant Contact Information – SWRCB_155
- Fraud Reporting Form – SWRCB_158
- Power of Attorney - SWRCB_160
- Project Execution Plan (PEP) 4.0 (August 04, 2023)
- Request for Change in Claimant or Joint Claimant Identification - SWRCB_167
- Request to re-open a closed UST Cleanup fund claim - SWRCB_170
Claim Eligibility
- Certificate of Compliance with Health & Safety Code Section 25299.54(h) - SWRCB_107
- Permit Compliance Certification Form
- Commingled Plume Account Application Package
- Permit waiver (for claims filed after 1/1/08) - SWRCB_159
- Request for assignment of Claim to priority class B - SWRCB_166
- USTCF Claim Application
- Worksheet for priority class B claimants - SWRCB_172
- Payee Data Record (STD 204) – Form is required for each entity that is receiving funding from the State Water Board. Submit this form when the entity’s name, tax status or mailing address for receiving the Form 1099 changes. (NOTE: Mailing address supplied on this form is where the entity will receive their potential Form 1099 at the end of each tax year.) (Link to Form: https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std204.pdf)
- STD. 204 Form Review Process (Link to File: https://www.waterboards.ca.gov/water_issues/programs/ustcf/docs/forms/form_review_process_flowchart.pdf
- STD. 204 Form Review Process (Link to File: https://www.waterboards.ca.gov/water_issues/programs/ustcf/docs/forms/form_review_process_flowchart.pdf
- Payee Data Record Supplement (STD 205) – Form only is required for an entity that is receiving funding from the State Water Board to mailing addresses that are different than the one listed on the STD 204. (NOTE: Mailing address supplied on this form is where the entity will receive payments from the State Water Board.) (Link to Form: https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std205.pdf)
- Government Agency Taxpayer ID Form – This form is required to be on file for any government agency that is receiving funding from the State Water Board. Submit this form when the mailing address changes. (NOTE: This form can only be used by government agencies). (Link to Form: https://fiscal.ca.gov/wp-content/uploads/2019/08/GovtTINForm_000.pdf)
- Proof of Payment Affidavit - SWRCB_161
- Proof of Payment Certification - SWRCB_162
- Provider’s Complaint Form for Claimant’s Nonpayment of Eligible Costs Form - This form can be submitted via mail, email, or fax
- Request for Appeal - SWRCB_165
- Request for extension - SWRCB_169
- Certification of Non-Recovery - SWRCB_153
- Conditions of Payment - SWRCB_157
These forms can only be submitted via US Mail with original signature
