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Sts Test Form

This document is a test certification form for storage tank systems as required by regulations in Newfoundland and Labrador, Canada. It contains sections for: [1] owner/operator information; [2] test details like date, type of test, and reason for test; [3] a sketch of tank systems; [4] test results; and [5] certification of tester and owner. The form is used to document inspections and tests of storage tank systems to ensure they are not leaking and meet regulatory requirements.

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139 views2 pages

Sts Test Form

This document is a test certification form for storage tank systems as required by regulations in Newfoundland and Labrador, Canada. It contains sections for: [1] owner/operator information; [2] test details like date, type of test, and reason for test; [3] a sketch of tank systems; [4] test results; and [5] certification of tester and owner. The form is used to document inspections and tests of storage tank systems to ensure they are not leaking and meet regulatory requirements.

Uploaded by

sugiantobarus
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Regional Ofices

Storage Tank System


Test Form Mount Pearl (709) 729-
Harbour Grace (709) 945-
Test Certification Form as Clarenville 3107
(709) 466-
required Gander 4060
(709) 256-
Grand Falls-Windsor 1420
(709) 292-4206
under The Storage and Corner Brook (709) 637-2204
Handling of Happy Valley-Goose (709) 896-5428
Bay
Gasoline and Associated Products
Regulations

Information
1 Name of Tank Owner or Operator

Address

Tank Serial Number


Date of Test

Test Performed By Company Affiliation of Tester

Reason for Test (please check) Type of Test Used (please check)
2 New or altered or repaired system set into Hydrostatic (Underground systems)
operation Request 48 hour dip (aboveground vertical
from Department 3 systems) Visual (Overhead
System being Horizontal Tanks) Pressure
abandoned (Piping Systems)
Storage Tank System in Electrical Potential (Cathodic Protection
critical area Storage Tank Systems) Percolation
System in sensitive area Other (Dyking Systems)
(specify) Other (specify)

Information
4 Attach a sketch of all storage tank systems at location, indicating which systems were tested.
Test Results (please
check) Undetermined Leak in Storage Tank Dyke Permeability Satisfactory
5 Leak in Tank
System

System Liquid Tight Electrical Potential


Leak in Satisfactory
Piping Hydrostatic A. Duration of Test
Test
Pressur Litres Accum. Percolation Test Result:
Time
e Injected or Temp.
o Vol.
(Kilopascals Drained C Change
B. Final Accum. Vol. Change: L
2
/m /d

C. Result (B/A): Electrical Potential Measured:

mV

48 Hour Dip Dip Pressure Test o


Test Time Readin Litres Change Temp. C
g
Dip o
Time Readin Litres Change Temp. C
g

I / We certify that the information supplied on this form is complete and accurate.

Tester Date Storage Tank System


Owner or Operator

02 01 70 009c_2014 05

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