Line Leak Detector and Line Tightness Test Form - Idaho

This "Line Leak Detector and Line Tightness Test Form" is a Idaho-specific form released by the Idaho Department of Environmental Quality on May 1, 2018.

Download the form by clicking the link below, fill it out by hand, and mail it as per the guidelines provided by the department or the applicable legal instructions.

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Idaho Department of Environmental Quality
Line Leak Detector and Line Tightness Test Form
Inspection Date:
Line Leak Detector and Line Tightness Test Form
Person Conducting the Testing
UST Facility
Name:
ID#:
Name:
Street Address:
Company Name:
City:
Zip Code:
Address:
Site Contact:
Phone:
Email:
Phone:
Test Type
New Site
Annual Test
Retest after Repair or Modification
Line Tightness Test
3 gph Leak Detector
0.2 gph Leak Detector
Testing equipment used:
Technician certification #:
Line Leak Detector Test Information and Results
A 3 gph "Fail" is an automatic line leak detector that cannot detect a leak of 3 gph at 10 psi.
A 0.2 gph "Fail" is an electronic line leak detector that cannot detect a leak of 0.2 gph at operating pressure.
Tank Number
Product Stored
Manufacturer
Model Number
Test Leak Rate
Other
Pass/Fail
3 gph
0.2 gph
3 gph
0.2 gph
3 gph
0.2 gph
3 gph
0.2 gph
3 gph
0.2 gph
3 gph
0.2 gph
3 gph
0.2 gph
3 gph
0.2 gph
Notes (replacement, etc.):
Tester's Signature (All testing was performed according to to manufacturer's instructions and 40 CFR 280.) Date
May 2018
Page 1 of 2
Idaho Department of Environmental Quality
Line Leak Detector and Line Tightness Test Form
Inspection Date:
Line Leak Detector and Line Tightness Test Form
Person Conducting the Testing
UST Facility
Name:
ID#:
Name:
Street Address:
Company Name:
City:
Zip Code:
Address:
Site Contact:
Phone:
Email:
Phone:
Test Type
New Site
Annual Test
Retest after Repair or Modification
Line Tightness Test
3 gph Leak Detector
0.2 gph Leak Detector
Testing equipment used:
Technician certification #:
Line Leak Detector Test Information and Results
A 3 gph "Fail" is an automatic line leak detector that cannot detect a leak of 3 gph at 10 psi.
A 0.2 gph "Fail" is an electronic line leak detector that cannot detect a leak of 0.2 gph at operating pressure.
Tank Number
Product Stored
Manufacturer
Model Number
Test Leak Rate
Other
Pass/Fail
3 gph
0.2 gph
3 gph
0.2 gph
3 gph
0.2 gph
3 gph
0.2 gph
3 gph
0.2 gph
3 gph
0.2 gph
3 gph
0.2 gph
3 gph
0.2 gph
Notes (replacement, etc.):
Tester's Signature (All testing was performed according to to manufacturer's instructions and 40 CFR 280.) Date
May 2018
Page 1 of 2
Idaho Department of Environmental Quality
Line Leak Detector and Line Tightness Test Form
Product Line Test Information and Results (Test for 1 hour at 1.5 times the operating pressure unless stated by manufacturer.)
Line
Time
Pressure (psi)
Volume (gallons)
Comments
Pass/
Number
Before
After
Before After
Net Change
(type of line, bleedback, etc.)
Fail
Notes (replacement, etc.):
Tester's Signature (All testing was performed according to to manufacturer's instructions and 40 CFR 280.) Date
May 2018
Page 2 of 2

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