LAC 55:IX.159. Required Forms and Reports

A. The following forms and/or reports shall be filed with the Office of the Director. 1. Installation Reports shall be properly completed and witnessed by the customer or his/her authorized representative. This includes installed or re-installed tanks and the completed form shall be maintained in the dealer’s files. These documents shall be made available to the commission within 15 days of request. Pressure tests shall be documented on the installation report when a container is installed or reinstalled. In other cases where pressure tests are required (See §167 and §175), the pressure tests may be filed with the commission on an installation report form and noted as such. Documentation of pressure tests shall be maintained by the dealer. 2. Sketches shall be filed with the office of the director for initial approval. Final approval shall be granted by the office of the director after installation but prior to placing into service the following liquefied petroleum gas systems: a. dealer bulk storages; b. liquid withdrawal systems, except systems for private use; c. places of public assembly, schools, churches, hospitals, nursing homes and other similar systems (either liquid or vapor systems); d. automatic dispensers used for motor fuel as required by LAC 55:IX.163.C; e. sketches for Class VI-X installations shall be filed with the office of the director for initial approval. The commission reserves the right to allow this installation to be placed in service prior to final inspection. Upon inspection, if this installation is deemed to be out of compliance with the commission’s rules and regulations, the servicing dealer shall remove all LPG cylinders from the installation within 24 hours. Dealer shall correct all deficiencies and then request a final inspection and approval of the installation. The installation shall remain out of service until final approval is granted by the commission. 3. reports of fires and accidents in accordance with §125. 4. documentation in accordance with §147. 5. proof of insurance or financial security in accordance with §107.A.3 or §107.A.3.a. 6. drawings in accordance with §113.A.11.c. 7. Reports in accordance with §107.A.6.a. 8. Location approval forms shall be in accordance with §113.A.3.b. Location Approval Form The submission of this form by a Class III dealer representative does not absolve the dealer of following the rules and regulations established by this Commission concerning the storage of liquefied petroleum gas. Due to the fact that all requisite details are not submitted regarding the storage locations referred to on this this form, it is, therefore assumed when approval is made on the information submitted, details regarding information not provided will comply with all regulations. Any changes to the cylinder location will require a new form to be submitted. Name of Class III dealer submitting this form:_________________ Name of Dealer supplying gas:_____________________________ Is storage location protected from vehicular impact? ___Yes ___No Is storage location: _____ inside building or _____outside building? Is storage location the proper distance from electrical equipment, ignition sources, doors and windows? _____Yes _____No Is Name of Class III Dealer, Supplier and 24 hour Emergency Contact on storage location? ____Yes ____No Is all the proper signage displayed at storage location? ____Yes ____No Does the public have access to the cylinder storage location? ____Yes ____No If yes, please ensure sketch is submitted by properly permitted dealer. Contact information for someone at cylinder location: Name ________________________________________________ Telephone Number _____________________________________ Please give brief description of storage area including distances to permanent reference points: _______________________________________________________ _______________________________________________________ All information submitted on this form has been verified as correct, and it is understood that any changes to this form shall require a new form to be submitted. Signed (person in charge of insuring correctness of this form) X__________________________________________________ Date:_______________ FEE $150.00