Health Department Tank Notification Forms

ABANDONMENT OF NON-LEAKING UNDERGROUND TANKS:

Homeowner Statement:
You must notify the the Nassau County Department of Health, in writing, seven days in advance of the abandonment or removal and use the Bureau of
Environmental Protection Affirmation of Non-Leaking Tank form (PDF)

Contractor Statement: seven days in advance of the abandonment or removal to the Nassau County Department of Health.
Your contractor must submit the Small Facility/Homeowner Tank Abandonment Notification Form (PDF)

Removal of Aboveground and Basement Tanks

You contractor must notify the the Nassau County Department of Health, in writing, seven days in advance of the removal and use the
Tank Abandonment/Removal Notification Form (PDF)

Please Note : original Affirmation Form must be notarized. Completed forms with appropriate fee must be mailed or delivered in person to the Bureau of Environmental Protection, Nassau County Department of Health, 106 Charles Lindbergh Blvd, Uniondale, New York, 11553.