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HI.Compliance Certification Complete this section if the release was detected on or after January 1, 1994. 1. Before you discovered the release, were all USTs that contributed upgraded to 1998 standards (USTs and piping protected from corrosion,spill buckets installed and overfill prevention equipment installed)? No If you answered"yes,"provide the following data;if you answered"no,"please skip down to question 2. If you need additional room,complete the Extra Corrosion Protection and Spill/Overfill Worksheet. Type of Tank Type of Piping Date Type of Date Volume Corrosion Corrosion Protection Type of Spill Overfill Protection Tank# (gals.) Contents Protection Protection Installed Protection Protection Installed 1 1500 Diesel FRP Composite Flexible 6/1/1996 Catchment Basin Auto Shutoff 6/1/1996 2 1500 Gasoline FRP Composite Flexible 6/1/1996 Catchment Basin Auto Shutoff 6/1/1996 2. Before January 1, 1994,did the owner or operator notify the Department of their intent to permanently close or upgrade the UST(s)to the 1998 technical standards,commence the closure/upgrade before July 1, 1994,complete the closure/upgrade before January 1, 1995 and report the release before January 1, 1995? No If you answer"yes",attach a copy of the notification. IV.Attachments 1. Scaled site map with location and i.d.#for all USTs and ASTs(former and current). Include location of product lines. Show relation to property lines and structures.Please indicate sample locations. 2. Copy of the"24 Hour Report"and test results showing soil and/or groundwater contamination. 3. Documentation to verify the last date that each UST or AST was used. Examples include; petroleum distributor invoices with last product delivery date,gas company statement with connection date indicated,AST installation invoice or third-party affidavits from disinterested individuals(affidavits from the applicant or family members/relatives will not be accepted). 4. Documentation verifying when the applicant acquired the property containing the UST(deed to the property). 5. If AST(s)(former or current)are associated with the site,please provide documentation that the discovered contamination is not from the AST(s). Documentation may consist of,but is not limited to,soil test(s)obtained by shallow soil borings in the vicinity of the tank or fractionation/fingerprint testing of the existing plume. 6. If the release was detected on or after January 1, 1994 and the tanks met the 1998 upgrade requirements, attach dated copies of invoices and receipts for all equipment and services needed to comply with upgrade. Inspection reports approved (signed) by Regional Office staff of the UST Section conducted prior to the release discovery will suffice. Copies of UST-7 or UST-8 forms will not suffice. 7. If tasks for which reimbursement will be sought were completed more than one year ago from when this application will be submitted, provide documentation verifying when the most recent task was completed(invoice for the activity with the task number as defined by the Reasonable Rate Document). 4 DWM/UST V.8/1/19