CPD Form 102.2 "Certification of Prover Cleaning" - South Carolina

What Is CPD Form 102.2?

This is a legal form that was released by the South Carolina Department of Agriculture - a government authority operating within South Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 19, 2019;
  • The latest edition provided by the South Carolina Department of Agriculture;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of CPD Form 102.2 by clicking the link below or browse more documents and templates provided by the South Carolina Department of Agriculture.

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Download CPD Form 102.2 "Certification of Prover Cleaning" - South Carolina

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South Carolina
DEPARTMENT OF AGRICULTURE
METROLOGY LABORATORY
129 Ballard Court, West Columbia, SC 29172
Hugh E. Weathers, Commissioner
CERTIFICATION OF PROVER CLEANING
Before submitting provers for calibration, the South Carolina Metrology Laboratory requires that all surfaces of the provers
(inside and outside) must be cleaned of all petroleum product and residues. Also, any drain line, pump, hose or storage tank
used in the calibration must also be free of petroleum and petroleum residue. Provers deemed by the metrology staff to not
be sufficiently clean will be refused and returned for cleaning. Cleaning will not be allowed at the laboratory.
A signed copy of this Certification of Prover Cleaning Form and a Calibration Request Form
must be on file for each prover before they are accepted for calibration.
Owner’s Name
Address
City, State, Zip
Contact Name
Phone
Manufacture
Capacity (Gallons)
Serial Number
I certify that the above described prover has been cleaned, inside and outside, and is free of petroleum product and residue. All drain lines,
hoses, pumps or storage tank submitted for use in the calibration of this prover have also been cleaned and is free of petroleum and residue.
Signature
Date
Printed Name
F O R D E PA R T M E N T U S E O N LY
Test Number
Date of Test
1
CPD Form # 102.2
2/19/19
South Carolina
DEPARTMENT OF AGRICULTURE
METROLOGY LABORATORY
129 Ballard Court, West Columbia, SC 29172
Hugh E. Weathers, Commissioner
CERTIFICATION OF PROVER CLEANING
Before submitting provers for calibration, the South Carolina Metrology Laboratory requires that all surfaces of the provers
(inside and outside) must be cleaned of all petroleum product and residues. Also, any drain line, pump, hose or storage tank
used in the calibration must also be free of petroleum and petroleum residue. Provers deemed by the metrology staff to not
be sufficiently clean will be refused and returned for cleaning. Cleaning will not be allowed at the laboratory.
A signed copy of this Certification of Prover Cleaning Form and a Calibration Request Form
must be on file for each prover before they are accepted for calibration.
Owner’s Name
Address
City, State, Zip
Contact Name
Phone
Manufacture
Capacity (Gallons)
Serial Number
I certify that the above described prover has been cleaned, inside and outside, and is free of petroleum product and residue. All drain lines,
hoses, pumps or storage tank submitted for use in the calibration of this prover have also been cleaned and is free of petroleum and residue.
Signature
Date
Printed Name
F O R D E PA R T M E N T U S E O N LY
Test Number
Date of Test
1
CPD Form # 102.2
2/19/19