Fill Station – Letters of Acknowledgements

Please sign the letter of acknowledgment below. If you are a staff member, fill out the form on the first tab. If you are the owner or manager, please fill out the form on the second tab.

Staff

    I acknowledge that I have received instructions, in verbal, written and/or in video form, on the recommended procedures to follow when transferring LP-gas from a dispenser system. I have performed the transfer operation under the direct supervision of a trained company supervisor or a representative from Devaney Energy.

    I further acknowledge that:

    1. I have completed the training video series “Dispensing Propane Safely”.
    2. I have passed the quiz that follows the program
    3. I have reviewed a list of instructions listed below
    4. I will contact my supervisor for any assistance and/or additional materials needed to safely dispense propane.


     

    THESE INSTRUCTIONS INCLUDE:

    1. A.S.M.E. containers and D.O.T. cylinders failing to meet applicable standards shall not be filled.
    2. No smoking within 15 feet of a transfer operation.
    3. Turn off engine and eliminate other sources of ignition.
    4. Insure that the vehicle, mobile trailer, etc. is not occupied.
    5. Suitable gloves must be worn during the transfer operation.
    6. Safety glasses must be worn during the transfer operation.
    7. Check at valve (including safety relief valve) and hose connection for leaks.
    8. Attach hose end valve to tank or cylinder filling connection.
    9. Open main liquid valve on supply tank.
    10. Open hose end valve.
    11. Open fixed liquid level gauge on tank of cylinder.
    12. Start LP-Gas transfer pump.
    13. When filling by volume, close hose end valve when liquid appears (white mist) at fixed liquid level gauge.
    Stop pump.
    14. When filling by weight, close hose end valve when correct (calibrated) weight is reached. Stop pump.
    15. Visual float gauge(s) are not to be used to determine proper filling levels.
    16. Close fixed liquid level gauge.
    17. If tank or cylinder was filled through service valve--close this valve before disconnecting.
    18. Close main liquid valve on supply tank.
    19. Disconnect hose end valve. Make certain that pressure was reduced prior to final disconnect.
    20. Store hose end valve in a prescribed safe location.
    21. Replace cap on filling connection of tank or cylinder.
    22. Recheck fixed liquid level gauge to make sure it is tightly closed.
    23. Install POL plug on cylinders up to 45 lbs. propane capacity.
    24. If required, apply D.O.T. labels and NLPGA cylinder warning label (#0004).

    I acknowledge that I have all necessary equipment (safety glasses, protective gloves, leak-detection fluid) and training to safely dispense and sell propane gas.

    Owners/Managers

      I acknowledge that I have received instructions, in verbal, written and/or in video form, on the recommended procedures to follow when transferring LP-gas from a dispenser system. I have performed the transfer operation under the direct supervision of a representative from Devaney Energy.

      I further acknowledge that I have been given access to the training video series “Dispensing Propane Safely” and I am responsible for the training of those individuals employed by my company delegated the task of dispensing LP-gas from this dispensing system. I will use the following suggested guidelines to present this training.

      1. Review the complete video series “Dispensing Propane Safely” provided on DevaneyEnergy.com and complete the assigned quiz accessed from the website.
      2. Provide access and instruct all staff members to register and complete the online program.
      3. Have the employees physically demonstrate and review the transfer operation procedures under my supervision.
      4. Review list of instructions with employees (page 2)
      5. I will contact training@devaneyenergy.com to schedule hands on training and for any assistance and/or additional materials needed to complete these safety training procedures.

      THESE INSTRUCTIONS INCLUDE:

      1. A.S.M.E. containers and D.O.T. cylinders failing to meet applicable standards shall not be filled.
      2. No smoking within 15 feet of a transfer operation.
      3. Turn off engine and eliminate other sources of ignition.
      4. Insure that the vehicle, mobile trailer, etc. is not occupied.
      5. Suitable gloves must be worn during the transfer operation.
      6. Safety glasses must be worn during the transfer operation.
      7. Check at valve (including safety relief valve) and hose connection for leaks.
      8. Attach hose end valve to tank or cylinder filling connection.
      9. Open main liquid valve on supply tank.
      10. Open hose end valve.
      11. Open fixed liquid level gauge on tank of cylinder.
      12. Start LP-Gas transfer pump.
      13. When filling by volume, close hose end valve when liquid appears (white mist) at fixed liquid level gauge.
      Stop pump.
      14. When filling by weight, close hose end valve when correct (calibrated) weight is reached. Stop pump.
      15. Visual float gauge(s) are not to be used to determine proper filling levels.
      16. Close fixed liquid level gauge.
      17. If tank or cylinder was filled through service valve--close this valve before disconnecting.
      18. Close main liquid valve on supply tank.
      19. Disconnect hose end valve. Make certain that pressure was reduced prior to final disconnect.
      20. Store hose end valve in a prescribed safe location.
      21. Replace cap on filling connection of tank or cylinder.
      22. Recheck fixed liquid level gauge to make sure it is tightly closed.
      23. Install POL plug on cylinders up to 45 lbs. propane capacity.
      24. If required, apply D.O.T. labels and NLPGA cylinder warning label (#0004).

      I acknowledge that I have viewed the PERC training series “Dispensing Propane Safely” with all employees who will operate the dispensing station. I have all necessary equipment (safety glasses, protective gloves, leak-detection fluid) and training to safely dispense and sell propane gas.