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Storage Tank System Operating Permit Application

 

Facility Information:

 

Is the owner information same as above?
 
Is the billing information same as above?
 

Applicable changes over the past 12 months:

Have you or anyone else made any alterations to this storage tank system?
 
Have you or anyone else removed or decommissioned any portion of this storage tank system?
 
Have you or anyone else installed a new tank?
 

Attachments:

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Site Maintenance:

I agree this is the responsibility of the owner and/or operator to ensure storage tank sites are maintained in a manner that complies with the requirements of the NFCAE. Dispensing equipment is regularly inspected, tanks are monitored for leaks, fire safety plans are in place and staff are trained in their duties.

Pursuant to s. 33 (c) of the Freedom of Information and the Protection of Privacy Act, the personal information collected on this form is for the purpose of an operating program or activity of the City of Medicine Hat. The City of Medicine Hat must collect personal information directly from the individual that the information is about unless another method of collection is authorized by the individual or by an enactment of Alberta or Canada. The personal information provided will be protected under Part 2 of the Freedom of Information and the Protection of Privacy Act and will be used for processing your application.

Questions regarding the collection and use of personal information can be directed to the FOIPP Head of Local Body at 403-529-8234.

By submitting this application/form you acknowledge and agree that any electronic signature provided by you herein is the same as a handwritten signature for the purposes of legality, validity, enforceability, and admissibility.

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