Form Mo 780 1262 PDF Details

The Mo 780 1262 form serves a crucial function within the framework of Missouri's approach to environmental protection, specifically in regulating air pollution through the meticulous monitoring of delivery vessels' emissions. Crafted by the Missouri Department of Natural Resources' Air Pollution Control Program, this document's primary purpose is to certify that delivery vehicles used in the transportation of gasoline meet stringent standards for vapor emissions. Such certification not only ensures compliance with federal regulations under 40 CFR 60.500 (Subpart XX) and 40 CFR 63.425 (Subpart R) but also underscores Missouri's commitment to safeguarding air quality. By requiring details like the vessel's make, year of manufacture, capacity, and the testing firm's credentials, the form comprehensively collects data critical for evaluating the environmental integrity of these mobile containers. Additionally, the form delves into specifics about the testing process, including initial test pressure and vacuum levels, compartment connectivity, and the adoption of vapor recovery methods. Importantly, the Mo 780 1262 form mandates that results from such evaluations—certifying a delivery vessel's compliance or non-compliance—are not only documented but also visibly maintained within the vessel itself and communicated to relevant terminals. This system of thorough reporting, mandated re-evaluation, and transparent certification epitomizes a proactive stance towards minimizing pollution from gasoline delivery systems.

QuestionAnswer
Form NameForm Mo 780 1262
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other names780 1262 f dnr form mo

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MISSOURI DEPARTMENT OF NATURAL RESOURCES

FOR OFFICE USE ONLY

AIR POLLUTION CONTROL PROGRAM

LOG #

DELIVERY VESSEL PRESSURE TEST

 

CERTIFICATION APPLICATION

CERT. #

 

 

 

 

EXP. DATE

 

 

 

REMARKS

 

 

TRUCK IDENTIFICATION

 

COMPANY NAME

 

 

 

MAILING ADDRESS

 

 

OWNER

 

 

 

 

 

 

 

 

 

 

 

 

 

TELEPHONE NUMBER WITH AREA CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OPERATOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DELIVERY VESSEL SERIAL NUMBER (OR TRUCK IF INTEGRATED UNIT)

 

 

 

 

 

 

 

 

 

MAKE AND YEAR OF MANUFACTURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DELIVERY VESSEL CAPACITY

 

 

 

 

 

 

 

 

 

 

 

NUMBER OF COMPARTMENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TESTING FIRM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF TESTING FIRM

 

 

 

 

 

 

 

 

 

 

 

TELEPHONE NUMBER WITH AREA CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MAILING ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF TESTER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DELIVERY VESSEL TEST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CAN DELIVERY VESSEL COMPARTMENTS BE CONNECTED?

 

 

 

 

 

 

 

 

 

 

 

ALUMINUM VAPOR HOODS

 

 

 

Yes

No

If no, each compartment must be separately tested and reported.

 

 

 

 

Yes

No

 

 

 

 

 

 

 

 

 

1

 

 

2

 

 

3

 

4

5

6

 

INITIAL TEST PRESSURE (Inches of H2O)

 

►

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

►

1

 

 

2

 

 

3

 

4

5

6

 

INITIAL TEST VACUUM (Inches of H2O)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THIS DELIVERY VESSEL MEETS THE STANDARD OF “NO MORE THAN

 

 

 

 

INCHES OF WATER DROP”

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

40 CFR 60.500 (SUBPART XX)

40 CFR 63.425 (SUBPART R)

 

 

 

OTHER

 

 

 

 

TEST STANDARD ►

YES

NO

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TEST RESULTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

 

2

 

 

3

 

4

5

6

 

PRESSURE LOSS IN 5 MINUTES IN COMPARTMENT

►

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

 

2

 

 

3

 

4

5

6

 

VACUUM LOSS IN 5 MINUTES IN COMPARTMENT

►

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VAPOR RECOVERY VENTS TESTED

 

 

VAPOR RAIL PRESSURE INCREASED BY

 

 

 

 

Yes

 

No

 

 

 

 

 

 

 

inches

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I, the undersigned, certify the delivery vessel described above has been tested in accordance with the procedures set forth in 40 CFR PART 60, Appendix A, Method 27.

SIGNATURE

DATE OF TEST

 

 

A copy of the latest certification must be kept in the delivery vessel at all times. One copy should also be sent to each bulk gasoline terminal at which the delivery vessel loads.

Return the completed test certification application to the Air Pollution Control Program, P.O. Box 176, Jefferson City, MO 65102.

MO 780-1262 (06-09)

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