Nebraska State Fire Marshal - Forms - Flammable Liquids Storage Tanks

Forms – FLST

Forms with a PDF format require Adobe Acrobat Reader to view the files. Forms with a format of DOT (Word template) require Microsoft Office 2000 or higher to view. These files, except where the format is indicated as Online, must be saved to your hard drive prior to completing them. To download these files, right click on the link and select “Save Target as…” Specify the Desktop or another directory on your hard drive, such as My Documents, where you want to save the file. Unless indicated otherwise, forms that require fees, signatures and/or other documentation must be mailed to the State Fire Marshal’s Office at 246 South 14^th Street, Lincoln, NE 68508-1804. If these forms are emailed it will delay processing.

Aboveground Storage Tank Registration – Hazardous Substances
Format: PDF File size: 65 KB
Posted:5/26/2004
Format: DOT File size: 103 KB
Posted:5/26/2004

This form must be completed by anyone storing hazardous substances in aboveground storage tanks. This form requires an original signature and fee paid by check or money order at the time the form is submitted.
Application for Contractor License
Format: PDF File size: 25KB
Posted:11/7/2007
Format: DOT File size: 103 KB
Posted:11/7/2007

Any company that wants to install and/or close underground storage tanks must complete this form. The application must be notarized.
Application for Individual Certification
Format: PDF File size: 40 KB
Posted:11/7/2007
Format: DOT File size: 118 KB
Posted:11/7/2007

Any individual seeking certification to install and/or close underground storage tanks should complete this application. The applicant’s signature must be notarized. This will require the form to be mailed to the Lincoln office.
Application for Individual Certification – Cathodic Protection Tester
Format: PDF File size: 26 KB
Posted:11/7/2007
Format: DOT File size: 116 KB
Posted:11/7/2007

Any individual seeking certification to test cathodic protection of underground storage tanks should complete this application. Since the application must be notarized it must be mailed to the Lincoln office.
Application for Permit to Install Aboveground Petroleum Storage Tanks
Format: PDF File size: 77 KB
Posted:8/30/2006
Format: DOT File size: 152 KB
Posted:8/30/2006

This application needs to be completed whenever an aboveground storage tank that will hold petroleum substances is to be installed. The application, with original signature, must be mailed to the Lincoln office with a check or money order covering the fee.
Application for Permit to Install Underground Storage Tanks
Format: PDF File size: 101 KB
Posted:10/19/2007
Format: DOT File size: 265 KB
Posted:10/19/2007

This application needs to be completed whenever an underground storage tank that will hold either petroleum or hazardous substances is to be installed. The application, with original signature, must be mailed to the Lincoln office with a check or money order covering the fee.
Application for Permit to Permanently Close Underground Storage Tanks and/or Piping
Format: PDF File size: 54 KB
Posted:02/27/2007
Format: DOT File size: 150 KB
Posted:02/27/2007

This application must be completed and approved by this office before an underground storage tank and/or piping is closed. An original signature is required. Therefore the application must be mailed to the Lincoln office.
Notification for Underground Storage Tanks
Format: PDF File size: 134 KB
Posted:8/30/2006

This form must be completed when notifying the State Fire Marshal of regulated underground storage tanks that have not previously been registered. This form will normally be used for a new installation and will be signed by both the owner and the installation contractor.
Notification of Change
Format: PDF File size: 134 KB
Posted: 03/30/2007

This form must be completed when notifying this office of a change in ownership, tank status, product stored or other facility information regarding regulated underground storage tanks. This form requires an original signature.
One Time Registration of Underground Storage Tanks
Format: PDF File size: 72 KB
Posted: 5/26/2004
Format: DOT File size: 123 KB
Posted: 5/26/2004

This form must be completed for: (1) Farm or Residential Motor Fuel Tanks (1,100 gallons or less), (2) Small Heating Oil Tanks (1,100 gallons or less), or (3) Tanks Permanently Abandoned as of January 1, 1974. Since an original signature is required on the registration form and a check or money order in payment of the fee this form cannot be emailed. It must be mailed to the Lincoln office.
Underground Storage Tank Registration Form for Heating Oil Tanks Over 1,100 Gallons
Format: PDF File size: 424 KB
Posted: 8/28/2006
Format: DOT File size: 178 KB
Posted: 6/16/2004

This form must be completed for all underground heating oil tanks over 1,100 gallons which are exempt under the requirement of the Federal Notification Program. This form requires an original signature and therefore must be mailed to the Lincoln office.

Page last updated November 14, 2007



MENU	Forms – FLST Forms with a PDF format require Adobe Acrobat Reader to view the files. Forms with a format of DOT (Word template) require Microsoft Office 2000 or higher to view. These files, except where the format is indicated as Online, must be saved to your hard drive prior to completing them. To download these files, right click on the link and select “Save Target as…” Specify the Desktop or another directory on your hard drive, such as My Documents, where you want to save the file. Unless indicated otherwise, forms that require fees, signatures and/or other documentation must be mailed to the State Fire Marshal’s Office at 246 South 14^th Street, Lincoln, NE 68508-1804. If these forms are emailed it will delay processing. Aboveground Storage Tank Registration – Hazardous Substances Format: PDF File size: 65 KB Posted:5/26/2004 Format: DOT File size: 103 KB Posted:5/26/2004 This form must be completed by anyone storing hazardous substances in aboveground storage tanks. This form requires an original signature and fee paid by check or money order at the time the form is submitted. Application for Contractor License Format: PDF File size: 25KB Posted:11/7/2007 Format: DOT File size: 103 KB Posted:11/7/2007 Any company that wants to install and/or close underground storage tanks must complete this form. The application must be notarized. Application for Individual Certification Format: PDF File size: 40 KB Posted:11/7/2007 Format: DOT File size: 118 KB Posted:11/7/2007 Any individual seeking certification to install and/or close underground storage tanks should complete this application. The applicant’s signature must be notarized. This will require the form to be mailed to the Lincoln office. Application for Individual Certification – Cathodic Protection Tester Format: PDF File size: 26 KB Posted:11/7/2007 Format: DOT File size: 116 KB Posted:11/7/2007 Any individual seeking certification to test cathodic protection of underground storage tanks should complete this application. Since the application must be notarized it must be mailed to the Lincoln office. Application for Permit to Install Aboveground Petroleum Storage Tanks Format: PDF File size: 77 KB Posted:8/30/2006 Format: DOT File size: 152 KB Posted:8/30/2006 This application needs to be completed whenever an aboveground storage tank that will hold petroleum substances is to be installed. The application, with original signature, must be mailed to the Lincoln office with a check or money order covering the fee. Application for Permit to Install Underground Storage Tanks Format: PDF File size: 101 KB Posted:10/19/2007 Format: DOT File size: 265 KB Posted:10/19/2007 This application needs to be completed whenever an underground storage tank that will hold either petroleum or hazardous substances is to be installed. The application, with original signature, must be mailed to the Lincoln office with a check or money order covering the fee. Application for Permit to Permanently Close Underground Storage Tanks and/or Piping Format: PDF File size: 54 KB Posted:02/27/2007 Format: DOT File size: 150 KB Posted:02/27/2007 This application must be completed and approved by this office before an underground storage tank and/or piping is closed. An original signature is required. Therefore the application must be mailed to the Lincoln office. Notification for Underground Storage Tanks Format: PDF File size: 134 KB Posted:8/30/2006 This form must be completed when notifying the State Fire Marshal of regulated underground storage tanks that have not previously been registered. This form will normally be used for a new installation and will be signed by both the owner and the installation contractor. Notification of Change Format: PDF File size: 134 KB Posted: 03/30/2007 This form must be completed when notifying this office of a change in ownership, tank status, product stored or other facility information regarding regulated underground storage tanks. This form requires an original signature. One Time Registration of Underground Storage Tanks Format: PDF File size: 72 KB Posted: 5/26/2004 Format: DOT File size: 123 KB Posted: 5/26/2004 This form must be completed for: (1) Farm or Residential Motor Fuel Tanks (1,100 gallons or less), (2) Small Heating Oil Tanks (1,100 gallons or less), or (3) Tanks Permanently Abandoned as of January 1, 1974. Since an original signature is required on the registration form and a check or money order in payment of the fee this form cannot be emailed. It must be mailed to the Lincoln office. Underground Storage Tank Registration Form for Heating Oil Tanks Over 1,100 Gallons Format: PDF File size: 424 KB Posted: 8/28/2006 Format: DOT File size: 178 KB Posted: 6/16/2004 This form must be completed for all underground heating oil tanks over 1,100 gallons which are exempt under the requirement of the Federal Notification Program. This form requires an original signature and therefore must be mailed to the Lincoln office. Page last updated November 14, 2007
246 South 14th Street; Lincoln, NE 68508-1804; Phone: (402) 471-2027; Fax: (402) 471-3118