Professional Documents
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Sts Test Form
Sts Test Form
Information
1 Name of Tank Owner or Operator
Address
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
mV
I / We certify that the information supplied on this form is complete and accurate.
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