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Storage Tank Local Government Guarantee without Standby Trust by a State

Form 62-761.900(3) Part M

Other Forms Needed, Examples, and Links

Guarantee Specific Guidance

  • Period of Coverage for the Guarantee: date of guarantee (first line) to "evergreen".
  • The Guarantee does not require (annual) updating unless its details change.

What to Do with Completed Forms

  • An owner or operator must maintain financial responsibility records (copies 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 M
Effective-Revision Date: 
Sunday, June 25, 2023
Last Modified:
July 7, 2023 - 9:07am

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