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Recommended Practices for the Tenirgand Vanfrtau°n of WifeO.wfik leak Detection ard Sxmdary Comermtnl Egapmsnl at USTkoSEes ! ME PEURP1200-17 it AUTOMATIC SHUTOFF DEVICE AND HALL FLOAT VALVE ii% Name: Owner, FaclineName: FasOxrcn Address Address. Address: Acki Owe slate, Zip coda: Citye SUte, ZIP Code: ID. Phone a: Cay, State, ZIP Code: Citi, State, ZIP Coda Tewng gmpp T yary, Phone f. eta: Factfly IDv In Phone t. lhls tlak shut bftt kspecthgautOmaUc ehvtottleY.ces ant �9 fbatwhes See PO/RP12(q Section 7 fw WPectbn prccedraes Product Grade Teekng Company. Phone F: Tank Number Thda procedure it to fest Ina leak on gray deontalnmem sumps. Sea PEr/HP12Do Section 6S fortne test method. Tank Volume gra Vons Containment Sump to i., Tank Damelar, Inches Overfin ProrrraMkn DeAce Brand COdahment Sump OAulomatlo OAIAomal : DAubmaW OAVlotnew ❑Mrtomaw ❑NRamstic ShubR Device Stuart Pestis ShrOR Device ShulaR Datta Shutoff Derta ShutoR Or4m Liquearddebns OYes ONO DWs ONO Dyes ONO Dyes ONO Dyes ONO Dyes ONO ❑ Ball Float OeaOFbat OWFIcat ❑Bal Float ❑ Ball Float OBeRfloat enke'1 (ram urmp?• Nta Whe Were Valve Were Yoko YeuN Wile dm via AUTOMATIC SHUTOFF DEVICE INSPECTION aac4s' Asosa Wrts OPass Ofail ❑ Pats ❑ Fag ❑ Pass ❑ Fan OP= ❑ Fag Open OFail ❑ Pass ❑ N11 10m9lube remaetl from tanK! OWs ONO OYes ONO OYes ONO DWS ONO Oyes ONO OYes ONO of separation of that mMahgneM sump.) 2'0I°p tube and Goat means- ❑Yes ONO OYes ONO OYes ONO Oyes ONO Dyes Otto DYas 1180 (MgainmeMSumD mama free of deers? Dem 3.Fbat mores ReaN vkthovl bAnding and poppet mores into DYes ONO Oyes ONO Oenas ONO OWs ONO OYu ONO DY ONO pelghtFmm Bauomm Roes "Ur?TOP of Highest Penetration q.Blpasssahe inure drop tube Oyes ONO Deletes ONO Oyes ONO Oyes ONO Oyes ONO OYes ONO Stating%laterlml .,,, open and heeofblocFaga Cd Offat Masera ONMPresent ONMesent PONot Present ❑ Not Present EINeAPreset Instant)? Test Start TMS S.FUpperatlheated to shut oR Dyes Duo Oyes ONo Dyes Ott° Oyes Olio Dyes Ditto OWs Olio Ooxat9554caFacip•1• Endug NTtarLnei A *1 b any hem In Ursa IS Ndrtates a last Wore. Ter End lett BALL FLOAT VALVE INSPECTION Test Period VAIMmum and Lruts°leapfdtlngs? sailor tlght Oyes ONO Dyes Oto Oyes ONO Oyes Olio Oyes Orb Dyes ONS testers: i hem) and eak- ],Cal Rest Sege has d deer's? ❑Yes Orb Oyes ONO OYea ONO Dyes ONO OYes Ott° WakrlsN Change 3. free holes andiled¢ Dyas ONO Oyes ONO DYes ❑ tk Oyes ONO Dyes ONO ❑Yes ONO Pass/(a8 arteria Must pass Vctb suel lnspan. Ylater iseel tlr°D o(ku Nan 1/6 Mich ' and eM rovescfreeN in Sege? Tat Reselh Di OFan Oleass ❑ Fal OPess OF ❑ Pass ❑ FeW ❑ Pass ❑Fan ❑ Pau ❑ Fag 4.Vanthole kphpeopanatd DYes ONO OYes ONO OYes ONo Oyu Oto Dyes ONO DYu ONO tear top of Setif! C°mmente: 5.8all float Pepe Proper length W restrkt Il mat Sara Oyes Oto OYes ONO Dyes ONO ❑Ya ONO Oyes ONO OYes ONO ', capacmR• • A 'N°' to any ham in lines 131ndka185 a test falure, Test Results OPass OFail I DPass Dean OPass OFail OPass OFai OPass 13 End OPass OFat Comments: • Ua manufacturers suggested pm &dvre for determineng Vautomatic shutaR device wail shut off fox at 95% capacity. '• fa ban feat 's found to ran the Inspection, another method dveRdi must to used. *0.4 hlquids aiW tlebrs must be disposed dpmperN• ***Use manufacturers suggested p Eusfor determining Vflax ralrcUOn devicew3l restrict Rax at90% capaM, Testers Name farm) Testers Signature Testers Name (print) Testers Signature pel.org @ Pel.org I i Runom irded Practices or theTestn9 and VUi6caden of SA Onva leak Dertedon and secondary Cornoment Equipment at UST Whirs �',. � PEURP1200-17 AUTOMATIC TANK CAUGE OVERFILLAILARM OPERATION INSPECTION OPERATIONINSPECTIr FacTry Name: Noon Fact y Name: OrmSr: Address: Address: Address: Address: city, Sire, ZIP Code: cdy, Sister LP Cede: gty. Sbte. LD cods: Cott teak, LP (ode: to cgry I.D. F: Phone N: Facey LD, IF: Phone F: Rstkng lbmpem^ Phoma g: Date: Testing Company: phone t. Date: Raw ee 2 fordhe TNpproretlureoletletermire anther the high IstelalarmbOpciailaal arW*le nigger vitenthe tank btiO more than 0% NIL Insp Promdureardwe. ispocedureI Oreaslmato tanki mender derStems oat ouproch the haomofth2005eWmsplena. Sse PEVRP"W Becton 73 Mr the especibn procsdura This pneasonre b applleade k tank keel momor stems that touch ted Inspactbn procedure. Tnls procedwe k epporede to tank keel moMlor stens thaltoutlt to batlom of the tankxhen In peace. hattom Of the tank viten in place. Tank Number Tankhumber Product Stated Prodod Shred ATG Brand and Model Tank fa%el Mondor Brand and Model LTank Wlume, Rotors LTank hlme, Reliant 2.Tank Dometer, Inches 2Tan1k Dameter, Inches 3.After remvAng the ATG from Viva tank h has 3.0.erfiR alarm ecthates in thetari mode rthe i inspectnt ed aa lar damaged or metsoployesONO g Oyes ONO Dyes ONO Oeres ONO mrecb? OWs ONO Oyes ONO Dyes ONO Oyes ONO parts notes"? d.N'nen activated, Ortrfi9 soon mnbe heard or 4.Fbal manes ireeN On the stem satthout OYes ONO OYa ONO Oyes Orb Oyes ONO een *iJe OeC'ngfO the Can Dyes ONO Dyes ONO OYes ONO Oyes ONO binding? 5,Aertem Angthepmbefromthetank hives 5.Fuellbat knot egress with tae wluaDb OYas Orb Dyes ❑NO DV'es ❑ tin Oyes ONO been ispectad and arty damaged a meieR Dyes ONO ❑Yes ONo ❑Vas Olio Dyes ONO gramnewintothecoesde? parts taplacedl 6.Watar fl°al keel agrees xfih the what pro- Oyes Orb Oyes ONO OYa ONO OWs ON° 6,Feat annas treaty an live stem%shout Nndi Oyes ONO Oyes ONO Dyes ONO Oyes ONO grarnmsd Into Na cereals? 7. n J+ k%el from eortom Of stem xhen 90% 7, Maing Dreduct IONVI feet up the Stem trigger Dyes Olio OYea ONO Oyes ONO Oyes ONO alarm Is Mggeree. alum? fi West stvid chthe mvicalalarm activates & Inds k%TI from batrom d stem *hen 90% alarm corresponds *M Value Wgrammed in the Oyes ONO 13 yes ONO DYas ONO OYes Otto is hignpred. gauge? 9,Tank rokrme at Inch level In Una 9, 9,inch kraal from the betoom when the rater Joe fkkubte (tine 9/ Lie 1) x 100 Opal firbt tiggors an alarm. 10. Inch feel at *filch One %Vett feel alum ac4 SL IS Ute d0less Wn90%? OyesONO Dense ONO Oyes LINO DYES ONO cotes corresponds teeth %slue programmed to DYas ONO OYes ONO Dents ONO ❑Y Dile 12. Wel Haat krel on the console agrees v'th Its the gauge? gauge stick reading? DYa Ohio ❑Yes ❑ rlO ❑Yes ❑ No ❑Yea No R am ansaere in Lines 3, 4, 5, w6 are 'rli the sastm hes fated the lest. 13, Devoid ah nn actisales at amy Productoval Dyes ONO ❑Ws ONO DYas ❑ No ❑ Yes ❑ No Teat Results OPaa OFaR Open Deal Ofeaso . OFan OPass OFali soave 90% tank capacAy! Commands: V amt ensxers in Una3, 4, Be Be 7 or11 am "NO; or Ute l3 b 'Yes; the system has fated tho tut Teri RuuNa uPass ❑ Fa8 ❑ Pass ❑ Fah ❑ Pass ❑Fag ❑ Gass ❑ Fal Comments: Teetered Name (print) Testers SlEnature Testers Name (pant) Testers Signature ® pei.org pei.org