Adem Form 414 PDF Details

Did you know that there are two types of Adem forms? There is the Adem form 414, which is for foreign nationals, and the Adem form 413, which is for domestic nationals. If you need to apply for a visa or residency permit in Turkey, you will need to use the Adem form 414. The process can be confusing, so let's take a look at what each form requires. The Adem form 414 is used by foreign nationals who want to apply for a visa or residency permit in Turkey. This form is more complicated than the Adem form 413, so it's important to understand what each section requires. In this blog post, we'll take a look at the different sections of the Adem

QuestionAnswer
Form NameAdem Form 414
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesForm414 statistical inventory reconciliation form

Form Preview Example

SIRM O N

ADEM MONTHLY STATISTICAL INVENTORY RECONCILIATION (SIR) REPORT FOR THE MONTHLY PERIOD FROM ___/___/___ TO ___/___/___

INSTRUCTIONS

1.If, for any reason, the test is neither “pass” nor “fail”, the “inconclusive” column must be marked under the "SIR Monthly Results" section below.

2.For “Leak Threshold”, “Minimum Detectable Leak Rate”, and “Estimated Leak Rate”, values must be in gallons per hour (gph).

3.When required by the "Reporting and Recordkeeping Requirements" section below, a completed ADEM Monthly SIR Report form should be sent to

 

the following address:

Alabama Department of Environmental Management

 

 

 

Groundwater Branch/UST Compliance Unit

 

 

 

Post Office Box 301463

 

 

 

Montgomery, Alabama 36130-1463

 

 

 

OWNER INFORMATION

 

 

Facility Name:

 

 

 

 

 

Owner:

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

City, State, Zip Code:

 

 

 

 

 

City, State, Zip Code:

 

 

 

 

 

 

 

Facility I.D. No.:

 

 

 

 

 

Phone Number: (

)

-

 

 

 

 

 

 

 

 

 

 

 

 

VENDOR INFORMATION

 

 

 

 

 

 

 

 

SIR Vendor:

 

 

 

 

 

Phone Number: (

)

-

 

 

 

 

 

 

SIR Vendor Contact:

 

 

 

 

 

SIR Version:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIR MONTHLY RESULTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THIS MONTHLY PERIOD

 

 

 

LAST MONTHLY PERIOD

 

ADEM

 

Tank

 

Tank

No. days

Leak

 

Minimum

 

Estimated

p

f

i

p

f

i

 

Unique

 

Contents

 

Capacity

of

Threshold

 

Detectable

 

Leak Rate

a

a

n

a

a

n

 

tank no.

 

 

 

(gallons)

inventory

(LT)

 

Leak Rate

 

(ELR)

s

i

c

s

i

c

 

 

 

 

 

 

data

(1)

 

(MDL)

 

(3)

s

l

o

s

l

o

 

 

 

 

 

 

 

 

 

(2)

 

 

(4)

(5)

n

(4)

(5)

n

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(6)

 

 

(6)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1)The Required Performance Standard (RPS) must be no greater than 0.2 gph. The SIR Vendor may set the RPS lower if desired.

(2)The Leak Threshold (LT) is normally set at one half of the RPS by the SIR Vendor and third-party certified at that level. However, the LT may be set at any level below the RPS by the SIR Vendor and third-party certified at that level.

(3)The Estimated Leak Rate (ELR) is the calculated amount the tank appears to be losing.

(4)A “pass” occurs when the ELR is less than the LT and the MDL is less than or equal to the RPS.

(5)An “inconclusive” occurs when the ELR is less than the MDL and the MDL is greater than the RPS.

(6)A “fail” occurs EITHER when the ELR is greater than or equal to the LT and the MDL is less than or equal to the RPS OR when the ELR is greater than or equal to the MDL and the MDL is greater than the RPS.

REPORTING AND RECORDKEEPING REQUIREMENTS

1.If any monthly SIR Vendor report indicates a “fail” or "inconclusive" for any tank system, you are required to:

(a)Perform an investigation of all tank systems that SIR Vendor indicates a "fail" or "inconclusive" within 7 days after receipt of SIR Vendor report.

2.If above investigation indicates that a suspected release caused the tank system(s) “fail” or "inconclusive" report, you are also required to:

(a)Report a suspected release to ADEM at 334/270-5655 within 24 hours after completion of investigation;

(b)Perform a tightness test on tank system(s) with a suspected release within 7 days after completion of above investigation;

(c)Submit system tightness test results, results of investigation and completed ADEM Monthly SIR Report form to ADEM within 10 days after completion of above investigation.

3.If above investigation indicates that factors other than a suspected release caused the tank system(s) “fail” or "inconclusive" report, you are only required to:

(a)Submit results of investigation and completed ADEM Monthly SIR Report form to ADEM within 10 days after receipt of SIR Vendor report.

4.If above investigation indicates that factors other than a suspected release caused the tank system(s) “fail” or "inconclusive" report, and a second consecutive monthly SIR Vendor report indicates that the same tank system did not "pass" ("fail" or "inconclusive"), you are required to:

(a)Report a suspected release to ADEM at 334/270-5655 within 24 hours of receipt of the second SIR Vendor report;

(b)Perform a tightness test on the tank system(s), where SIR Vendor report indicated the same tank system(s) did not "pass", within 7 days of receipt of the second SIR Vendor report;

(c)Submit system tightness test results and completed ADEM Monthly SIR Report form to ADEM within 10 days after receipt of the second SIR Vendor report that indicated the same tank system(s) did not "pass".

5.The tank owner is required to have an ADEM Monthly SIR Report form for each tank system on file 20 days after the monthly test period.

6.A Leak Threshold (LT), Minimum Detectable Leak Rate (MDL), and Estimated Leak Rate (ELR) must be on file for each tank. If they are not provided, the tank system(s) is not in compliance with leak detection requirements for that month.

CERTIFICATION

I certify under penalty of law that I am familiar with the information submitted on this form and that based on my inquiry of those individuals immediately responsible for obtaining the information I believe that the information is true, accurate, and complete.

Signature of owner/operator:________________________________________________________________________Date:______________________

ADEM Form # 414 8/02

Issue Date: 5/28/99

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Adem Form 414 conclusion process outlined (portion 1)

2. When the prior section is filled out, go to type in the suitable information in all these - p a s s , p a s s , i n c o n , i n c o n , The Required Performance Standard, REPORTING AND RECORDKEEPING, and If any monthly SIR Vendor report.

Filling out part 2 of Adem Form 414

Be very careful while filling out p a s s and p a s s , because this is where many people make errors.

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Filling in part 3 of Adem Form 414

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