Laserfiche WebLink
SUBMITTAL DATE: _______________________ <br />Test Date and Time <br />TANK TESTER INFORMATION <br />UNDERGROUND STORAGE TANK <br />TANK AND LINE INTEGRITY TESTING, AND ENHANCED LEAK <br />DETECTION TEST NOTIFICATION FORM <br />OFFICE OF TANK TESTER LICENSING <br />OTTL@waterboards.ca.gov <br />Test notifications for testing tank and line integrity testing, and enhanced leak detection (ELD) <br />testing are required to be submitted to the Office of Tank Tester Licensing (OTTL) in accordance <br />with the California Code of Regulations, tile 23, chapter 17, section 2772. If changes to test <br />notifications occur after submittal to OTTL, please notify OTTL of those changes immediately. <br />Using this form, provide OTTL with the following information when submitting test notifications: <br />FACILITY INFORMATION <br />CERS ID <br />Facility Name <br />Facility Address City ZIP Code <br />Company Performing the Test Phone <br />Mailing Address <br />Licensee Name <br />OTTL License # Expiration Date <br />TEST METHOD INFORMATION <br />Test Method Components Tested <br />Post Construction ELD: Is the form for post construction contractor statement attached? <br />YES NO If no is selected, provide general contractor statement prior to testing. <br />Failure to comply and provide all of the above information may result in disciplinary action against <br />licensed tank tester. Please note that this notification does not waive the requirement for the 48- <br />hour notice to the local agency in accordance with the provisions of California Code of Regulations, <br />title 23, chapter 16, sections 2643(g) and 2644.1(a)(4). <br />June 2020