Example of Tank Schedule Attachment

When the number of facilities exceeds the space available on any of the Form 62-761.900(3) parts, or if the provider company prefers to attach a facility list or when this list is amended, we recommend the attachment include the following elements:

  • The word “Attachment” (such as “Attachment: Facility/Tank Schedule dated XX/XX/XXXX”)
  • The date
  • Type of financial assurance instrument it accompanies
  • Rule required elements
    • Facility identification number (FacID) for facilities in Florida
    • Facility Name (should match the name registered when obtaining the placard)
    • Site Address (matching the registration)
    • Identify the number of regulated tanks (or list tank ID numbers)
  • Additional information such as tank size and location (UST/AST) is acceptable

A fillable PDF Attachment/Amendment example is available near the top of this page.  An MS Word version of the example is available below.

Return to the Financial Assurance Forms (Mechanisms) webpage

Return to the Financial Responsibility General Guidance (FAQs) webpage

Form Number: 
62-761.900(3) example facility-tank schedule
Effective-Revision Date: 
Friday, August 27, 2021
Last Modified: Friday, Dec 13, 2024 - 05:45pm