Liquid Fuel Measuring Instruments Verification Record Form

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Liquid Fuel and Lubricants
Authorised Person: / Job Reference Number: / Date of Verification:
Make / Location of Verification:
Model
Type
Class /

Type Approval Certificate (TAC) No

Peripherals etc /

Test Certificate (TC) No(s)

Serial No(s) /

Complies with TAC?

Yes  No 

Preliminary Examinations & Observations
Inscriptions: /

Pass  Fail 

/ Re-qualification / Yes  No 
TAC conditions if applicable / Pass  Fail  / All EIGHTS display test / Pass  Fail 
Peripherals appropriately marked/labelled / Pass  Fail  / Confirm measures ‘wet’ and level before use / Pass  Fail 
Confirm priming run ≥ 10 litres before test / Pass  Fail  / Price to pay computer / Customer display / Pass  Fail 
Adverse environmental conditions
(Specify below if applicable) / Yes  No  / Indicated temp range,  for default (-10C to +40C), specify if not
Card reader receipt legibility & accuracy /

Pass  Fail 

/ Kiosk Control Unit checks
Total number of seals
Positions for verification & control marks, sealing arrangements (e.g. calibration wheel, meter to frame, meter casing), plus comments on the verification and any other tests
Accuracy Testing
The Measuring Instruments (Liquid Fuel and Lubricants) Regulations 2006 SI 1266 Schedule 5 Part 1 and 2 Class 0.5
Minimum test requirements: 20 litres, 10 litres and minimum delivery fast; 10 litre and min delivery slow.
FAST DELIVERY (full operating speed).
SLOW DELIVERY (as near as practically 10% of the maximum flow rate stated in the notice of approval. For standard pumps this will be approximately 4.5L/min, high speed diesel pumps will be 7.5L/min, and for super-high speed diesel 12L/min).
DRAINAGE TIME (Metal: 20l and 10l = 60 seconds; 5l and 2l = 30 seconds).
DRIP STOP NOZZLES (e.g. Elaflex ZVA) Minimum delivery marked as 5 litres (WM634)
Enter the error (+/-ml or %)
Fast delivery / Slow delivery
Pump No. / Grade Tank No: / Dripstop nozzle fitted? / 20 l / 10 l / 5 l / 2 l / 20 l / 10 l / 5 l / 2 l / Total Fuel used (l): / OverallResultPass / Fail
Yes/No / O
Yes/No / P
Yes/No / T
Yes/No / I
Yes/No / O
Yes/No / N
Yes/No / A
Yes/No / L
P.L.E. / 20 litre, 10 litre and 5 litre: +/-0.5% (+/- 100ml; +/- 50ml; +/- 25ml)
Min delivery: 2 litre (5 litre if dripstop nozzle fitted)+/-1.0%(+/- 20ml +/- 50 ml)
Pass  / Fail 
Verification marks applied / Yes  No 
Serial no. of certificate of conformity / non-conformity:
If fail, ‘Rights of Appeal’ notice issued? / Yes  No 
dd / mm / yyyy
Authorised verification officer / Date
dd / mm / yyyy
Reviewing Officer / Date
Traceability and Calibration Control of Standards and Test Equipment
The Measuring Instruments (Liquid Fuel and Lubricants) Regulations 2006; NWML 7321 of March 2002 (Specification for Working Standards of Capacity – Metal Contents Measures) or NWML7323 of December 2003 (Specification for Working Standards of Capacity – Integrated Measures). Only identification and description required if using own measures.
20 litre / 10 litre / 5 litre / 2 litre
Identification
Brief description
Calibration date
Certificate no.
Issued by

Liquid Fuel| Test Report | Version 2 |1/3