UNIFIED OPERABILITY TEST FORM

Location Name

Location Address

Tank Monitor Type

Technician Name

Technician Certification

Work Order

Send Report To


TANK 1 Product Name:

Tank Diameter (inches): Tank Volume (gallons):

STP SUMP / PRODUCT 1 PICTURE

STP Type / Manufacturer


TANK PROBE Probe Removed for Inspection: YesNo
Product and Water Readings Verified: YesNo Floats Present and in Good Condition: YesNo
TEST RESULT Fail Reason

LINE LEAK DETECTION Product State if Leak Detected: RestrictedStopped
Line Leak Detector Type: MechanicalElectronic Pump On Pressure:
Simulated 3 GPH Leak Detected: YesNo Pump Off Pressure:
TEST RESULT Fail Reason

OVERFILL PROTECTION Description:
Overfill Protection Type: Device Removed, Inspected & in Good Condition: YesNo
Overfill Valve Set at 95% Tank Volume: YesNo Audible Alarm Activates at 90% Tank Volume: YesNo
Upper Tube Length: Riser Pipe Length:
Ball Float Set at 90% Tank Volume: YesNo Ball Float Length:
TEST RESULT: Fail Reason:

SENSORS & GAUGES
Device Location & Type example: STP Sump Sensor (L1)
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

SPILL BUCKETS & SUMPS

HYDROSTATIC TEST: FILL SUMP TO 4" ABOVE TOP ENTRY / MINIMUM TEST TIME = 1 HOUR (1/8 inch per hour gain or loss = FAIL)
SINGLE WALL CONTAINMENTS AND SUMPS EVERY YEAR / DOUBLE WALL CONTAINMENTS AND SUMPS EVERY THREE YEARS
Containment Type & Name example: Single Wall Spill Bucket
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason


TANK 2 Product Name:

Tank Diameter (inches): Tank Volume (gallons):

STP SUMP / PRODUCT 2 PICTURE

STP Type / Manufacturer


TANK PROBE Probe Removed for Inspection: YesNo
Product and Water Readings Verified: YesNo Floats Present and in Good Condition: YesNo
TEST RESULT Fail Reason

LINE LEAK DETECTION Product State if Leak Detected: RestrictedStopped
Line Leak Detector Type: MechanicalElectronic Pump On Pressure:
Simulated 3 GPH Leak Detected: YesNo Pump Off Pressure:
TEST RESULT Fail Reason

OVERFILL PROTECTION Description:
Overfill Protection Type: Device Removed, Inspected & in Good Condition: YesNo
Overfill Valve Set at 95% Tank Volume: YesNo Audible Alarm Activates at 90% Tank Volume: YesNo
Upper Tube Length: Riser Pipe Length:
Ball Float Set at 90% Tank Volume: YesNo Ball Float Length:
TEST RESULT: Fail Reason:

SENSORS & GAUGES
Device Location & Type example: STP Sump Sensor (L1)
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

SPILL BUCKETS & SUMPS

HYDROSTATIC TEST: FILL SUMP TO 4" ABOVE TOP ENTRY / MINIMUM TEST TIME = 1 HOUR (1/8 inch per hour gain or loss = FAIL)
SINGLE WALL CONTAINMENTS AND SUMPS EVERY YEAR / DOUBLE WALL CONTAINMENTS AND SUMPS EVERY THREE YEARS
Containment Type & Name example: Single Wall Spill Bucket
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason


TANK 3 Product Name:

Tank Diameter (inches): Tank Volume (gallons):

STP SUMP / PRODUCT 3 PICTURE

STP Type / Manufacturer


TANK PROBE Probe Removed for Inspection: YesNo
Product and Water Readings Verified: YesNo Floats Present and in Good Condition: YesNo
TEST RESULT Fail Reason

LINE LEAK DETECTION Product State if Leak Detected: RestrictedStopped
Line Leak Detector Type: MechanicalElectronic Pump On Pressure:
Simulated 3 GPH Leak Detected: YesNo Pump Off Pressure:
TEST RESULT Fail Reason

OVERFILL PROTECTION Description:
Overfill Protection Type: Device Removed, Inspected & in Good Condition: YesNo
Overfill Valve Set at 95% Tank Volume: YesNo Audible Alarm Activates at 90% Tank Volume: YesNo
Upper Tube Length: Riser Pipe Length:
Ball Float Set at 90% Tank Volume: YesNo Ball Float Length:
TEST RESULT: Fail Reason:

SENSORS &, GAUGES
Device Location & Type example: STP Sump Sensor (L1)
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

SPILL BUCKETS & SUMPS

HYDROSTATIC TEST: FILL SUMP TO 4" ABOVE TOP ENTRY / MINIMUM TEST TIME = 1 HOUR (1/8 inch per hour gain or loss = FAIL)
SINGLE WALL CONTAINMENTS AND SUMPS EVERY YEAR / DOUBLE WALL CONTAINMENTS AND SUMPS EVERY THREE YEARS
Containment Type & Name example: Single Wall Spill Bucket
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason


TANK 4 Product Name:

Tank Diameter (inches): Tank Volume (gallons):

STP SUMP / PRODUCT 4 PICTURE

STP Type / Manufacturer


TANK PROBE Probe Removed for Inspection: YesNo
Product and Water Readings Verified: YesNo Floats Present and in Good Condition: YesNo
TEST RESULT Fail Reason

LINE LEAK DETECTION Product State if Leak Detected: RestrictedStopped
Line Leak Detector Type: MechanicalElectronic Pump On Pressure:
Simulated 3 GPH Leak Detected: YesNo Pump Off Pressure:
TEST RESULT Fail Reason

OVERFILL PROTECTION Description:
Overfill Protection Type: Device Removed, Inspected & in Good Condition: YesNo
Overfill Valve Set at 95% Tank Volume: YesNo Audible Alarm Activates at 90% Tank Volume: YesNo
Upper Tube Length: Riser Pipe Length:
Ball Float Set at 90% Tank Volume: YesNo Ball Float Length:
TEST RESULT: Fail Reason:

SENSORS & GAUGES
Device Location & Type example: STP Sump Sensor (L1)
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

SPILL BUCKETS & SUMPS

HYDROSTATIC TEST: FILL SUMP TO 4" ABOVE TOP ENTRY / MINIMUM TEST TIME = 1 HOUR (1/8 inch per hour gain or loss = FAIL)
SINGLE WALL CONTAINMENTS AND SUMPS EVERY YEAR / DOUBLE WALL CONTAINMENTS AND SUMPS EVERY THREE YEARS
Containment Type & Name example: Single Wall Spill Bucket
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason


DISPENSER SENSORS

Device Location & Type example: Dispenser 1 & 2 Sump Sensor (L2)
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

Device Location & Type
TEST RESULT Fail Reason

DISPENSER SUMPS
HYDROSTATIC TEST: FILL SUMP TO 4" ABOVE TOP ENTRY / MINIMUM TEST TIME = 1 HOUR (1/8 inch per hour gain or loss = FAIL)
SINGLE WALL CONTAINMENTS AND SUMPS EVERY YEAR / DOUBLE WALL CONTAINMENTS AND SUMPS EVERY THREE YEARS

Containment Type & Name example: Single Wall Sump (Dispenser 1 & 2)
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason

Containment Type & Name
Start Time     End Time
Start Reading End Reading
TEST RESULT Test Type Fail Reason


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