Click to resize the text + -
Nebraska State Fire Marshal

Jim Heine, State Fire Marshal

Forms

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 14th Street, Lincoln, NE 68508-1804. If these forms are emailed, it will delay processing.

 

Aboveground Storage Tank Registration – Hazardous Substances

PDF

DOT

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

PDF

DOT

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

PDF

DOT

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

PDF

DOT

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

PDF

DOT

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

PDF

DOT

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

PDF

DOT

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

PDF

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

PDF

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

PDF

DOT

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

PDF

DOT

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.