Transcription of P R O PANE BOBTA I LAND TRANSPORT …
1 Testing of Emergency Discharge Control SystemDelivery Hose ID #: Manufacturers name: Date Hose Tested and Assembled://After inspection of the complete length of hose, I certify that the following:1. The hose is free of defects such as bulges, cuts, cracks or other noticeable damage. Yes *No2. The hose couplings and threads are free of defects, corrosion, excessive wear or slippage. Yes *No3. On bolted hose coupling assemblies, there are no loose or missing bolts or fastenings. Yes *No1. Pipe and joints are free of corrosion, excessive wear or damage. Yes *No2. Seals are free of excessive wear and leaks. Yes *No3. Bolts, flanges, bracket and couplings are all present and show no damage. Yes *No4. Stainless steel or rubber hose flexible connectors show no damage or excessive wear. Yes *NoPropane Servicer:Vehicle ID #Insp.
2 Date://Address/Location:Trailer #MonthThis vehicle inspected and tested is a: Bobtail TRANSPORT THIS VEHICLE PASSES ALLCHECKS BELOW (Driver Signature)P R O PANE BOBTA I LAND TRANSPORT MONTHLYINSPECTION FORM 49 CFR 2: Piping System InspectionSystem used on this vehicle for emergency discharge control is: Flowmatic/Automatic type Manual typePhysical Inspection1. Levers and/or switches are operational, intact and show no damage. Yes *No2. Cables and/or pneumatic actuators are operational, intact and show no damage. Yes *No3. Cables and/or pneumatic lines are in good condition and show no excessive wear or damage. Yes *No4. Thermal links are in place and in good condition. Yes *NoPart 3: Emergency Discharge Control Devices Inspection and Te s t i n gPart 4: Defects and ReportingDefects Noted:Date Corrected_____/_____/_____/_____/_____/_ ____/_____This is to certify that the above defects were noted and repaired in accordance with CFR 49 CFR guidelines.
3 Thisvehicle has passed all inspection and testing requirements noted above and is considered safe for Mechanic s Signature:Date: _____/_____/_____Inspectors/Driver s Signature:Date: _____/_____/_____* Note: All items marked with an * must be qualified and explained in detail in Part 4 of this form* Compliance dates vary. Check current PREMIERSAFETYSERVICES/PROPANERESOURCESFo r Reorder Contact: Propane Resources. Phone: 913-262-0589PR02 (4/07)Part 1: Delivery Hose Assembly InspectionMetered+ Number of seconds to stop:(see below)~ Creep after first 5 seconds: *Yes NoNon-meteredThere are no detectable leaks 30 seconds after closure Yes *No+ If number of seconds exceeds 30, then this vehicle has failed the test and is unsafe to operate. Please report repair details in Part 4.~There can be no creep in next 5 seconds after meter stops.
4 Please report repair details in Part 4.
