"Annual Automatic Tank Gauging Equipment Inspection Form" - Mississippi

This "Annual Automatic Tank Gauging Equipment Inspection Form" is a Mississippi-specific form released by the Mississippi Department of Environmental Quality on January 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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Download "Annual Automatic Tank Gauging Equipment Inspection Form" - Mississippi

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MISSISSIPPI DEPARTMENT OF ENVIRONMENTAL QUALITY
ANNUAL AUTOMATIC TANK GAUGING EQUIPMENT INSPECTION
➢ This form may be utilized to document the proper operation of automatic tank gauging (ATG) equipment.
Date of Inspection
➢ ATG equipment that is utilized to meet the tank or pipe leak detection requirements is required to be inspected
once every 12 months. ATG maybe conducting monthly 0.2 gph leak tests or Statistical Inventory Reconciliation.
➢ In the absence of a recognized industry procedure or manufacturer’s recommended practice, the methodology
outlined below (see “MDEQ Automatic Tank Gauging Equipment Inspection Procedure”) may be utilized.
UST Facility
Person Conducting Inspection
Facility Name
MDEQ Facility ID #
Inspector’s Name
Physical Address
Company
City
County
State
MDEQ Certification #
Expiration Date
MS
Inspector’s Signature
UST Owner
Date
Automatic Tank Gauging Equipment Identification
Manufacturer
Model
Console Serial Number
Tank 0.2 gph leak tests: (
Static
Continuous)
Statistical Inventory Reconciliation
Type of Leak Detection
Electronic Line Leak Detector (0.2 or 0.1 gph leak test)
Other:________________________
MDEQ Automatic Tank Gauging Equipment Inspection Procedure
1. Inspect console and verify that it has no active or recurring history of 0.2 gph leak detection-related warnings or alarms.
2. Confirm that both the visual and audible alarms on the ATG console function correctly.
3. Verify that the correct set-up parameters are input and the automatic tank gauge is performing 0.2 gph leak testing.
4.
Measure the fuel and water contents of the tank and compare with the ATG inventory report ensuring that they are the same.
5.
Remove tank probes and clean ensuring all floats move freely without binding and that the probe is in good condition.
6.
Ensure that the probe fuel and water floats are the correct type for the product stored in the tank.
7.
Reposition the fuel and water floats, measure distance from bottom of the probe, and utilize tank charts to confirm accuracy of
the ATG report for all manually obtained fuel or water levels.
8.
Reinstall probes ensuring that the tank riser cap seals properly and the communication cable seal is tight.
If ATG is equipped with printer, attach the printed ATG set-up information to this form.
9.
Inspection Results for the Year
Tank / Compartment Identification
Probe Serial Number
Console functions are normal and no
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
alarm condition exists
Visual and audible alarms tested and
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
function correctly
Correct parameters are input and leak
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
testing performed
All tank probes are in good condition
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
and functioning properly
Manually obtained fuel levels indicate
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
ATG inventory is correct
Manually obtained water levels indicate
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
ATG inventory is correct
Tank cap, seals and communication
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
cable are in good condition
ATG Set-up Information attached
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Inspection Result (Pass/Fail)
Comments:
PRODUCED BY THE MISSISSIPPI DEPT. OF ENVIRONMENTAL QUALITY, OFFICE OF POLLUTION CONTROL, UST BRANCH
PO BOX 2261
JACKSON, MS 39225
PHONE (601) 961-5171
FAX (601) 961-5093
http:// www.deq.state.ms.us
1/18
MISSISSIPPI DEPARTMENT OF ENVIRONMENTAL QUALITY
ANNUAL AUTOMATIC TANK GAUGING EQUIPMENT INSPECTION
➢ This form may be utilized to document the proper operation of automatic tank gauging (ATG) equipment.
Date of Inspection
➢ ATG equipment that is utilized to meet the tank or pipe leak detection requirements is required to be inspected
once every 12 months. ATG maybe conducting monthly 0.2 gph leak tests or Statistical Inventory Reconciliation.
➢ In the absence of a recognized industry procedure or manufacturer’s recommended practice, the methodology
outlined below (see “MDEQ Automatic Tank Gauging Equipment Inspection Procedure”) may be utilized.
UST Facility
Person Conducting Inspection
Facility Name
MDEQ Facility ID #
Inspector’s Name
Physical Address
Company
City
County
State
MDEQ Certification #
Expiration Date
MS
Inspector’s Signature
UST Owner
Date
Automatic Tank Gauging Equipment Identification
Manufacturer
Model
Console Serial Number
Tank 0.2 gph leak tests: (
Static
Continuous)
Statistical Inventory Reconciliation
Type of Leak Detection
Electronic Line Leak Detector (0.2 or 0.1 gph leak test)
Other:________________________
MDEQ Automatic Tank Gauging Equipment Inspection Procedure
1. Inspect console and verify that it has no active or recurring history of 0.2 gph leak detection-related warnings or alarms.
2. Confirm that both the visual and audible alarms on the ATG console function correctly.
3. Verify that the correct set-up parameters are input and the automatic tank gauge is performing 0.2 gph leak testing.
4.
Measure the fuel and water contents of the tank and compare with the ATG inventory report ensuring that they are the same.
5.
Remove tank probes and clean ensuring all floats move freely without binding and that the probe is in good condition.
6.
Ensure that the probe fuel and water floats are the correct type for the product stored in the tank.
7.
Reposition the fuel and water floats, measure distance from bottom of the probe, and utilize tank charts to confirm accuracy of
the ATG report for all manually obtained fuel or water levels.
8.
Reinstall probes ensuring that the tank riser cap seals properly and the communication cable seal is tight.
If ATG is equipped with printer, attach the printed ATG set-up information to this form.
9.
Inspection Results for the Year
Tank / Compartment Identification
Probe Serial Number
Console functions are normal and no
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
alarm condition exists
Visual and audible alarms tested and
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
function correctly
Correct parameters are input and leak
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
testing performed
All tank probes are in good condition
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
and functioning properly
Manually obtained fuel levels indicate
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
ATG inventory is correct
Manually obtained water levels indicate
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
ATG inventory is correct
Tank cap, seals and communication
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
cable are in good condition
ATG Set-up Information attached
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Inspection Result (Pass/Fail)
Comments:
PRODUCED BY THE MISSISSIPPI DEPT. OF ENVIRONMENTAL QUALITY, OFFICE OF POLLUTION CONTROL, UST BRANCH
PO BOX 2261
JACKSON, MS 39225
PHONE (601) 961-5171
FAX (601) 961-5093
http:// www.deq.state.ms.us
1/18
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