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Storage Tank Local Government Fund


Form 62-761.900(3) Part O

Other Forms Needed, Examples, and Links

Local Government Fund Specific Guidance

  • The Chief Financial Officer (CFO) may have a title different from CFO, such as Clerk, Comptroller, Treasurer, etc. but the CFO title is unlikely to include the word "assistant" or "deputy". Other individuals may have the authority to sign, but they will be able to produce documentation demonstrating their authorization.
  • Details concerning additional documentation requirements are found in 40 CFR 280.111 and are summarized here:
    • Maintain a copy of the state constitutional provision or local government statute, charter, ordinance, or order dedicating the fund.
    • Maintain year-end financial statements for the most recent completed financial reporting year showing the amount in the fund.
      • If the fund is established using incremental funding backed by bonding authority:
        • The financial statements must show the previous year's balance, the amount of funding during the year, and the closing balance in the fund.
        • Maintain documentation of the required bonding authority, including either the results of a voter referendum or attestation by the State Attorney General.

What to Do with Completed Forms

  • An owner or operator must maintain financial responsibility records (a copy of the completed form parts with required supporting documentation) at the facility or at their business office.
  • If not kept at the facility, they shall be made available at the facility or another agreed upon location upon five business days notice by a department or county inspector.

Return to the Storage Tank Financial Assurance Forms (Mechanisms) webpage.

Form Number: 
62-761.900(3) Part O
Effective-Revision Date: 
Sunday, June 25, 2023
Last Modified:
July 7, 2023 - 9:07am

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