Request for variance to close in-place

Oklahoma Corporation Commission
Petroleum Storage Tank Program
P.O. Box 52000, Room 480
Oklahoma City, OK 73152
I. FACILITY INFORMATION
Facility Name: / Facility I.D. Number:
Facility Street Address:
City: / State: / County: / Zip:
Facility Phone: / Alternate Phone:
Email Address (Optional):

ii. Owner Information

Owner’s Name: / Business Name:
Business Address (Other than facility address):
City: / State: / County: / Zip:
Business Phone: / Business Mobile Phone:

iii. LICENSED REMOVER INFORMATION

Licensed Remover’s Name: / Remover’s State License #:
Business/Organization Name:
Business Street Address: / Phone Number:
City: / State: / County: / Zip:

iv. LICENSED Consultant INFORMATION

Licensed Consultant’s Name: / Consultant’s State License #:
Business/Organization Name:
Business Street Address: / Phone Number:
City: / State: / County: / Zip:

vi. List the amount of any fluids remaining in tanks to be closed in-place (Please Describe below)

(example: Tank #1 = 2 inches of unleaded 87) :
V. TANK INFORMATION
Number of Tanks for In-Place Closure: / Size of Tanks:
Age of Tanks: / Substance(s) Last Used in Tank(s):
Tank Construction Type (i.e. Steel, FRP, Fiberglass, etc.):
Will Piping Be Removed ?
YES | NO / Note: If piping is going to be left in place, samples will need to be acquired at 20 foot intervals along pipe trench.
Are there any other tanks located in the tank pit along with the tank(s) that this variance is being sought for? / YES | NO | UNSURE

vii. Reason why a variance for in-place closure is being requested

VIII. DESCRIPTION OF THE PROPOSED INERT MATERIAL TO BE USED

occ (PSTD) requirements for in-place closure

  1. In-place closures must be scheduled 14-days in advance after a variance has been granted.
  1. Tank(s) must be cleaned by removing all flammable and combustible liquid and residue from the tank and all connecting lines. Ensure the removed material is properly and safely disposed of in compliance with State and local regulations. (A manifest or invoice for all cleaning, and disposal services will be required to accompany the closure documentation).

  1. Excavate the top of the tank.

  1. Disconnect and/or remove all tank fixtures (excluding the vent line). The vent line should remain connected until the tank has been completely purged.

  1. Either purge the tank of flammable vapors, or inert the potentially explosive atmosphere in the tank.

  1. The tank should be tested to determine if it is safe by using one of the following procedures:
  2. When purging, a combustible gas indicator is used to measure the reduction in the concentration of flammable vapors. The meter reads from 0 to 100 percent of the LFL (lower flammable level). The goal is to achieve a reading of 10 to 20 percent LFL for petroleum tanks.
  3. When inerting, and oxygen meter or analyzer is used to determine when a tank has been successfully inerted. The meter reads from 1 to 10 percent, which is safe for most petroleum tanks.

  1. Sampling must be conducted as described in the OCC (PSTD) Sampling Requirements for In-place Closures document located on page 2.

  1. Fill the tank completely with anapproved inert solid material. NOTE: (Tanks approved for “In-place” closure must be completely filled with an approved, inert, solid material that has a density greater than water (e.g. sand, gravel, slurry, etc.), with the capability of retaining its density and shape forever).(A manifest or invoice indicating the amount of fill material used will be required to accompany the closure documentation).

8. / Map & photos that must accompany the closure documentation are as follows:
a)Site map of tank, dispenser and building locations including distances.
b)Photos of the site before procedures begin.
c)Photos of the tank excavation.
d)Photos of the removed tank fixtures.
e)Photos of the line capping or line removal.
f)A photo of the tank after the cleaning process has been completed.
g)Photos of the tank being inerted.
h)Photos of the holes cut into the top of the tank.
i)Photos of the tank completely filled with the inert material.
j)Photos of the site after backfill and completion.
(Print Only) Owner or authorized representative
X / Title:
(Signature) Owner or authorized representative / Date:
(Print Only) Licensed Remover
X / Title:
(Signature) Licensed Remover / Date:

occ (PSTD) committee review page

After a committee review of your request for variance from commission rule OAC 165:25-2-131, your request has been recommended.

Additional Comments:

After a committee review of your request for variance from commission rule OAC 165:25-2-131, your request has not been recommended.

Additional Comments:

NOTE:In the event your request for a variance is denied recommendation, you retain the right to appeal, and have your case heard by an Oklahoma Corporation Commission (OCC) Administrative Law Judge.

(Print Only) PSTD Staff Member
X / Title:
(Signature) PSTD Staff Member / Date:

FORM REVISED 15 AUG 2016 Page | 1