Title Page
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Client/Site
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Location/area name/plant number
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Conducted on
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Report by
General Information
Fluid Type
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Supplier
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Fluid type(s)
- Diesel Fuel
- Unleaded Petrol
- Other
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Other fluid type
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Obtain and attach fluids SDS to report
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Is a Hazardous Area Dossier available
Issues
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Reported/witnessed issues
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Images of issues
Electrical
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Is 240VAC available
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Preferred power supply method
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Other supply method
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Does installation comply with AS 3000
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Repairs/modifications required
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Does installation have lightning protection
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Type of lightning protection system
Communications
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Digital communications available
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Preferred comms type
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Comms type
- LAN
- Wireless LAN
- Other
Environment
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Maximum ambient temperature
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Location (Internet connection needed)
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IP rating requirements
- IP 56
- IP 57
- IP 58
- IP 66
- IP 67
- IP 68
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IP Standards
Fuel Management System
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Existing FMS system
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Type
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Location of depot
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Location of depot
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Data transfer
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Identification
- Manual pin
- Key
- Card
- Automatic
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Type
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Supply voltage
- 24VDC
- 12VDC
- 110VAC
- 240 VAC
- Other
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Is supply fed from mains
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Distance to distribution board
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Cable trays/ladders available
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Comms used
- LAN
- Wireless LAN
- Other
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Distance to network connection
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Repairs/mods required
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General Arrangement
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Add drawing
Incoming
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Incoming Fuel delivery is in this area
General Details
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Delivery method
- Road Train
- Delivery Pipe Line
- Port
- Service Cart
- Other
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Other delivery method
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Infrastructure owner
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Supplier
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Custody transfer point
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Estimated flow rate
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Considered satisfactory by owner
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Desired flowrate
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Feasible to increase
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Tank level indication visible at fill point
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Type
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Fuel sampling point(s)
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Fuel sampling conducted
Pipe work and protection devices
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Nominal diameter
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Incoming pipe work condition
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Repairs required
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Images of pipe work
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Meets AS1345 identification requirements
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Repairs required
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Images of pipe work
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Thermal relief used as required
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Fill point spillage containment
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Condition
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Typical unloading hose length
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Couplers
- Camlock
- Dry Break
- Cap/Plug
- Holster
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Isolation valve(s) fitted
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Isolation valve connection type and size
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Valve actuation type
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Energy used
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Voltage
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Delivery vehicle earthing
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Condition
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Check valve on inwards
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Connection type and size
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Condition
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Repairs required
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Images of check valve
Unloading
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Unloading technique
Pump
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Make
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Model
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Serial
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Pressure
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Flowrate
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Image of nameplate
Motor
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Make
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Model
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Voltage
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Connection (Star or Delta)
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Power
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RPM
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Frame size
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Flange size
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Image of nameplate
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Pump Set condition
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Repairs required
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Images of pump
Pump protection
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Strainer fitted
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Make
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Model
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Connection type and size
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Strainer mesh size
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No or low flow protection
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Protection type
- Flow switch
- Pressure switch
- Pressure relief
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Dry-run protection
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Dry-run protection method
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Duty standby
Water separation
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Water separator
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Make
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Model
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Serial number
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Flowrate
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Connection type and size
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Water indication
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Drainage point
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Pressure vessel certified
Bulk air elimination
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Bulk air eliminator
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Make
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Model
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Serial number
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Flowrate
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Connection type and size
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Pressure vessel certified
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Custody transfer approved
Filtration
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Filtration
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Make
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Model
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Serial number
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Flowrate
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Connection type and size
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Pressure vessel certified
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Roughing number and size of elements
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Polishing number and size of elements
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Isolation valves
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Condition indication
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Type of indication
- Local
- Remote
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Routine maintenance of filters/strainers
Flow meter
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Meter installed
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Make
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Model
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Serial number
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Flowrate
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Connection type and size
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Air eliminator
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Make
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Model
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Inlet strainer
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Make
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Model
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Custody transfer approved
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Outlet check valve
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Pulse output
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Make
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Model
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Serial number
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Register
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Make
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Model
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Serial number
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Temperature compensation
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Make
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Model
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Serial number
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Transaction recorded
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Calibration points
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Size and types of fittings
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Routine meter calibrations
Storage
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Storage Tanks
Tank
Tank information
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Tank identification number/name
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Fluid type
- Diesel Fuel
- Unleaded Petrol
- Other
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Other fluid type
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Infrastructure owner
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Supplier
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Have modifications been approved by Supplier
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Fuel owner
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Supplier
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Have modifications been approved by Supplier
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Tank type
- Horizontal Cylindrical
- Vertical Cylindrical
- Horizontal Elliptical
- Vertical Elliptical
- Spherical
- Rectangular
- Underground
- Self Bunded
- Other
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Tank Safe Fill Level
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Tank Maximum fill level
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Bund capacity satisfactory
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Bund integrity satisfactory
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Images of issues
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Issues - Notes
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Inspection cover(s)
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Images of inspection cover(s)
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Take note of tank entries, flanges/sockets and sizes
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Tank schematics available
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Acquire copies
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Tank Breather
- Free to air
- Filtered/desiccant
- Other
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Routine maintenance carried out
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Other breather type
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Are pressure/vacuum relief valves fitted
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Pressure/vacuum relief valves
- Pressure relief valve
- Vacuum relief valve
- N/A
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Images of devices
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Pressure ratings of devices
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Water drain(s)
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Is the drain within bund
Incoming isolation valve(s)
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Isolation valve(s) fitted
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Isolation valve(s) connection type and size
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Valve actuation type
- Manual
- Actuated
- Fire safe
- Normally closed
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Energy used
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Voltage
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Check valve on incoming
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Connection type and size
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Condition
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Repairs required
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Images of check valve
Outgoing isolation valve(s)
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Isolation valve(s) fitted
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Isolation valve(s) connection type and size
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Valve actuation type
- Manual
- Actuated
- Fire safe
- Normally closed
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Energy used
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Voltage
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Outlets secure and locked
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Check valve on outgoing
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Connection type and size
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Condition
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Repairs required
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Images of check valve
Tank Level indication
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Type
- Dip stick
- Sight gauge
- Electronic
- Mechanical
- Pressure
- Other
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Other type of manual level display
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Routine calibration checks
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Temperature compensation
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Automatic reconciliation
Overfill protection
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Overfill protection fitted
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Type
- Float switch
- Vibrating limit switch
- Pressure switch
- Tank level
- PLC
- Other
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Shut off method
Offline filtration
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Stock rotation
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Current fuel quality (ISO 4406)
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Offline filtration installed
Pump
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Make
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Model
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Serial
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Pressure
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Flowrate
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Image of nameplate
Motor
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Make
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Model
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Voltage
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Connection (Star or Delta)
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Power
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RPM
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Frame size
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Flange size
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Image of nameplate
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Pump Set condition
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Repairs required
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Images of pump
Filtration
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Filtration
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Make
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Model
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Serial number
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Flowrate
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Connection type and size
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Pressure vessel certified
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Roughing number and size of elements
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Polishing number and size of elements
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Isolation valves
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Condition indication
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Type of indication
- Local
- Remote
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Routine maintenance of filters/strainers
Dispensing
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Fuel dispensing in this area
Infrastructure
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Supplier
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Infrastructure owner
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Custody transfer point
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Fuel dispensing point
Dispensing point
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Fluid type
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Other fluid type
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Is a Hazardous Area Dossier available
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Acquire copy
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Type of dispensing point
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Make
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Model
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Serial number
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Image of bowser
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Hose length
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Size of hose
Pipe work
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Nominal diameter
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Dispensing pipe work condition
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Repairs required
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Images of pipe work
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Meets AS1345 identification requirements
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Repairs required
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Images of pipe work
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Thermal relief used as required
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Estimated flow rate
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Considered satisfactory by owner
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Desired flowrate
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Feasible to increase
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Safety valve installed
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Connection type and size
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Condition
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Repairs required
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Images of safety valve
Transfer control
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Transfer technique
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Motor control voltage
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Distance to Motor control center
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Control valve connection type and size
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Image of control valve
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Full detection method
- Float switch
- Vibrating limit switch
- Pressure switch
- Tank level
- PLC
- Other
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Other control system
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Motor control
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Motor control voltage
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Valve control
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Control valve connection type and size
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Actuator type
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Voltage
Pipe work
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Nominal diameter
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Dispensing pipe work condition
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Repairs required
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Images of pipe work
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Meets AS1345 identification requirements
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Repairs required
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Images of pipe work
-
Thermal relief used as required
-
Estimated flow rate
-
Considered satisfactory by owner
-
Desired flowrate
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Feasible to increase
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Check valve installed
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Connection type and size
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Condition
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Repairs required
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Images of check valve
Pump
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Make
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Model
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Serial
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Pressure
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Flowrate
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Image of nameplate
Motor
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Make
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Model
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Voltage
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Connection (Star or Delta)
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Power
-
RPM
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Frame size
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Flange size
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Image of nameplate
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Pump Set condition
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Repairs required
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Images of pump
Pump protection
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No or low flow protection
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Protection type
- Flow switch
- Pressure switch
- Pressure relief
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Dry-run protection
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Dry-run protection method
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Duty standby
Water separation
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Water separator
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Make
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Model
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Serial number
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Flowrate
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Connection type and size
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Water indication
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Drainage point
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Pressure vessel certified
Filtration
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Filtration
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Make
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Model
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Serial number
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Flowrate
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Connection type and size
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Pressure vessel certified
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Roughing number and size of elements
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Polishing number and size of elements
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Isolation valves
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Condition indication
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Type of indication
- Local
- Remote
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Routine maintenance of filters/strainers
Flow meter
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Meter installed
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Make
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Model
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Serial number
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Flowrate
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Connection type and size
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Air eliminator
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Make
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Model
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Inlet strainer
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Make
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Model
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Custody transfer approved
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Outlet check valve
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Pulse output
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Make
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Model
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Serial number
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Register
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Make
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Model
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Serial number
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Temperature compensation
-
Make
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Model
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Serial number
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Calibration points
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Size and types of fittings
-
Transaction recorded
-
Routine meter calibrations
Pipe work
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Nominal diameter
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Dispensing pipe work conditon
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Repairs required
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Images of pipe work
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Meets AS1345 identification requirements
-
Repairs required
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Images of pipe work
-
Thermal relief used as required
-
Estimated flow rate
-
Considered satisfactory by owner
-
Desired flowrate
-
Feasible to increase
-
Check valve installed
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Connection type and size
-
Condition
-
Repairs required
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Images of check valve
Pump
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Make
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Model
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Serial
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Pressure
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Flowrate
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Image of nameplate
Motor
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Make
-
Model
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Voltage
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Connection (Star or Delta)
-
Power
-
RPM
-
Frame size
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Flange size
-
Image of nameplate
-
Pump Set condition
-
Repairs required
-
Images of pump
Pump protection
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No or low flow protection
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Protection type
- Flow switch
- Pressure switch
- Pressure relief
-
Dry-run protection
-
Dry-run protection method
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Duty standby
Water separation
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Water separator
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Make
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Model
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Serial number
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Flowrate
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Connection type and size
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Water indication
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Drainage point
-
Pressure vessel certified
Filtration
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Filtration
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Make
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Model
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Serial number
-
Flowrate
-
Connection type and size
-
Pressure vessel certified
-
Roughing number and size of elements
-
Polishing number and size of elements
-
Isolation valves
-
Condition indication
-
Type of indication
- Local
- Remote
-
Routine maintenance of filters/strainers
Flow meter
-
Meter installed
-
Make
-
Model
-
Serial number
-
Flowrate
-
Connection type and size
-
Air eliminator
-
Make
-
Model
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Inlet strainer
-
Make
-
Model
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Custody transfer approved
-
Outlet check valve
-
Pulse output
-
Make
-
Model
-
Serial number
-
Register
-
Make
-
Model
-
Serial number
-
Temperature compensation
-
Make
-
Model
-
Serial number
-
Calibration points
-
Size and types of fittings
-
Transaction recorded
-
Routine meter calibrations
Delivery Method
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Hose support method
- Loading arm
- Hose reel
- Hose mast/tower
- Hose only
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Hose length
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Breakaway valve fitted
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Size of hose
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Make
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Model
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Rewind type
- Manual rewind
- Spring rewind
- Hydraulic rewind
- Pneumatic rewind
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Image of hose reel
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Hose length
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Break Out Point space (mm)
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Breakaway valve fitted
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Size of hose
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Make
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Model
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Image of hose mast/tower
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Hose length
-
Breakaway valve fitted
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Size of hose
-
Make
-
Model
-
Image of loading arm
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Hose length
-
Breakaway valve fitted
-
Size of hose
