AGRICHEM,&AL BULK STORAGE REGISTRATION Registration Package – Check-Off List

Facility _______________________________
City _________________________
Region _____
AGRICHEM,&AL BULK STORAGE REGISTRATION
Registration Package – Check-Off List
(items to submit to MDA5' for registratLRQ
Subject
Yes
No
Remarks
Yes
No
Remarks
Yes
No
Remarks
Is the front page complete?
Is the Summary Sheet complete?
Site Plan
Subject
Structures and wells on site?
Precipitation runoff routes to and from the storage
facility?
Approx. distance of any lakes, streams, drainage
ditches, storm drains within 0.5 miles of facility?
Distance and direction to the nearest public and
private wells?
Site soil characteristics?
Depth to ground water?
Horizontal, raised, or vertical tank situation at the
site specified?
Tank schedule for each tank with: construction
material, capacity, diameter, height, product stored?
Secondary and operational area containment plans
with capacity of the containment (gal)?
Operational plan for containment areas showing
handling and utilization of recovered agrichemical
materials, rinsewater, precipitation accumulation?
Aboveground Tank Inventory Form
Subject
Does the facility have pesticide tanks >400 gal
and/or fertilizer tanks >2,500 gal?
Is the Tank Inventory sheet complete?
(Rev. 8/13)