Traders Information

  • Trader

  • Traders Address
  • Date

  • Inspector

Instrument Information

Instrument Details

  • Make

  • Model

  • Serial Number

  • Approval Number

  • Instrument correctly states

  • Certificate of Accuracy

  • AP number

  • Select date

  • Pump Number

  • Fuel Grade

  • Mark of Verification

  • AP Number

  • 20L Fast (1)

  • Indicated

  • Actual

  • Total Price

  • Test Passed

  • 20L Fast (2)

  • Indicated

  • Actual

  • Total Price

  • Test Passed

  • 20L Slow

  • Indicated

  • Actual

  • Total Price

  • Test Passed

  • 5L

  • Indicated

  • Actual

  • Total Price

  • Test Passed

  • Preset Delivery

  • $ per Litre

  • Total Price Indicated

  • Litres Delivered

  • Test Passed

  • Pump Number

  • Fuel Grade

  • MOV

  • AP Number

  • MPE: @ 20 L = +/- 100 mL @ 5 L = +/- 25 mL Difference between 20 L Fast Runs < 40 mL

  • Mounting

  • Front and Rear Indicators

  • Interlock

  • Leaks

  • Hose Dilation

  • Anti Drain Valve

  • 20L Fast (1)

  • Indicated

  • Actual

  • Total Price

  • Test Passed

  • 20L Fast (2)

  • Indicated

  • Actual

  • Total Price

  • Test Passed

  • 20L Slow

  • Indicated

  • Actual

  • Total Price

  • Test Passed

  • 5L

  • Indicated

  • Actual

  • Total Price

  • Test Passed

  • Preset Delivery

  • $ per Litre

  • Total Price Indicated

  • Litres Delivered

  • Test Passed

  • Pump Number

  • Fuel Grade

  • MOV

  • AP Number

  • MPE: @ 20 L = +/- 100 mL @ 5 L = +/- 25 mL Difference between 20 L Fast Runs < 40 mL

  • Mounting

  • Front and Rear Indicators

  • Interlock

  • Leaks

  • Hose Dilation

  • Anti Drain Valve

  • 20L Fast (1)

  • Indicated

  • Actual

  • Total Price

  • Test Passed

  • 20L Fast (2)

  • Indicated

  • Actual

  • Total Price

  • Test Passed

  • 20L Slow

  • Indicated

  • Actual

  • Total Price

  • Test Passed

  • 5L

  • Indicated

  • Actual

  • Total Price

  • Test Passed

  • Preset Delivery

  • $ per Litre

  • Total Price Indicated

  • Litres Delivered

  • Test Passed

Instruments Information

  • Make

  • Model

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