E 
^ ^ ^ f^ 

DEQ 

state of Oregon 

Depai liiitint of 

Envlronmerrtal 

Quality 

OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY 

Underground Storage Tank Program 

CATHODIC PROTECTION TEST REPORT FORM 

COVER PAGE AND INSTRUCTIONS 

Steel imderground storage tank (UST) systems are required to have cathodic protection (CP) 

systems in order to prevent corrosion and possible failure of UST system components. These CP 

systems are required to be inspected and tested at regular intervals in order to demonstrate they 

are providing the necessary protection. This report form is intended to provide a format, 

technical references, and guidelines for adequate performance and documentation of cathodic 

protection (CP) system testing. 

CP System Testing Frequency and Reporting - Oregon Administrative Rule (OAR) 340-150-

0325(2), requires inspection and testing of CP systems within six months of installation and at 

least every three years thereafter. Owners and permittees of UST systems are required to report 

any failed CP system test results within 24 hours and submit a report ofthe test results. Passing 

CP system test results do not need to be reported to the DEQ. However, owners and permittees 

are required to keep records of CP system tests and must have the last two test results available 

for review during an inspection. Although only the last two CP test results are required to be 

kept, DEQ recommends that copies of all CP tests results be maintained for the operating life of 

the UST system. 

CP Testing Standards & References - Oregon rules specify that inspection and testing of CP 

systems must be done in accordance with the National Association of Corrosion Engineers 

(NACE RP-0285), "Standard Recommended Practice: Corrosion Control of Undergroimd 

Storage Tank Systems by Cathodic Protection." In addition, some UST manufacturers have 

specific procedures described for testing a CP system. For exarhple, the Steel Tank Institute (STI), 

which manufactures the commonly found STI-P3 tanks, has a recommended practice for CP 

testing as well as a manufacturer's certification for testing STI tanks. 

CP Test Station - Oregon Rules also require a permanent CP "test station" be installed or a 

written CP system test procedure be established. As described in OAR 340-150-0320(3)(d), a 

CP "test station" must have an electrical cormection to the structure (tank and/or pipe) and access 

for placing a reference cell. A written test procedure must contain sufficient detail to ensure 

repeatable test procedures. 

Steel Tank Integrity Assessment - Of critical importance in designing, installing, and testing of 

all CP systems is assessing the integrity or condition ofthe steel tank to be protected. Steel tanks 

and piping that have had CP systems installed must complete an integrity assessment of the steel 

tank as described by OAR 340-150-0560. Documentation ofthe integrity assessment must be 

kept with the permanent facility records and be available for review at the time of a DEQ 

inspection. 

March 2008 Page I of 5 06-LQ-019A 
Protection Of All UST System Components -Oregon Administrative Rule 340-150-0325(1), 

requires CP for all UST system components that routinely contain product. This includes all 

stainless steel flex-lines, steel fittings, and steel piping, including those in dispensers and sumps, 

that may be in contact with soil, backfill material, and water. These steel UST system 

components must be isolated from the soil, backfill and water or have a CP system installed. CP 

systems installed to protect these portions of a UST system must be tested just as the CP systems 

that protect the tank(s). 

UST System Modifications «& Repairs Notifications - Both 30 & 3 day notices are required to 

"modify" a UST system. Modifying a UST system includes installation of a CP system that did 

not previously exist. For example, installation of spike anodes or ankle bracelets to pipe and/or 

fittings that did not previously have CP. Another modification example would be installing an 

impressed current CP system after a galvanic system has failed. An example of a CP system 

repair would be installing new anodes after failure of existing anodes 

UST Supervisor & Service Provider Licenses - Installation, modification, testing, repair and 

replacement work with CP systems always requires both an Oregon CP Supervisor license and 

an Oregon Service Provider license. Design of field-installed CP systems must be done by a 

corrosion expert or engineer with appropriate background in CP system design. 

USE OF THIS FORM 

Use of this form is voluntary. DEQ offers this form with the intent to establish a format that 

captures all the relevant information collected during an impressed current or galvanic 

(sacrificial) cathodic protection test. A complete report for record keeping consists of either: 

Cathodic Protection Test Information Page (3) and 

Impressed Current CP Test Results Report Page (4) or Galvanic CP Test Results Report Page (5) 

HELP WITH THIS FORM 

If you have any questions about this CP system test report form, please phone your nearest DEQ 

Regional Office (see below for telephone numbers). You can also phone the UST Program's 

toll-free Oregon number, 1-800-742-7878. This is a message answering machine for calls made 

in Oregon. Underground Storage Tank Program staff will retum your call within 24 hours (one 

business day). You can also obtain UST program information from our web page at 

http://www.deq.state.or.us/lq/tanks/ust/index.htm 

NORTHWEST REGION 

Phone: (503) 229-5263 

WESTERN REGION / SALEM 

Phone: (503) 378-8240 

WESTERN REGION / EUGENE 

Phone:(541)686-7838 

WESTERN REGION / COOS BAY 

Phone:(541)269-2721 

EASTERN REGION/THE DALLES 

Phone: (541) 298-7255 

March 2008 Page 2 of 5 06-LQ-019A 
Oregon Departinent ofEnvironmental Quality 

Cathodic Protection Test Information Page 

UST Owner 

NAME: 

ADDRESS: 

CITY: : • STATE; 

UST Facility 

NAME: ID#: 

ADDRESS: 

CITY: STATE: 

Cathodic Protection Tester 

TESTER'S NAME: 

COMPANY NAME: 

ADDRESS: 

CITY: STATE: 

CP TESTER'S LICENSE #: 

EXPIRATION DATE: 

PHONE NUMBER: 

NACE CERTIFICATION #: 

Cathodic protection system is: | | Galvanic | | Infipressed current Date Last Tested: 

Weather Conditions at Time of Testing/Inspection: 

Temperature: Soil/Backfill Conditions (check V) moist dry pand gravel soil Describe soil: 

Cathodic Protection System Certification 

Identify which of the following testing situations is being recorded: 

Test required within 6 months of installation of CP system (installation date was ) 

1 J Test required at least every 3 years after installation/test noted above 

Test required within 6 months of any repair activity 

The cathodic protection system is effective, testing was performed according to NACE Standard RP-0285, 

^and is providing cathodic protection to all tanks and product lines: Yes No 

Signature of Tester Date 

UST SYSTEM INFORMATION 

TANK# YR TANK 

INSTALLED CAPACITY TANK MATERIAL LINED? Y/N Date 

:~M-M:\-^^M-/BQ^ 

YRCP 

INSTALLED 

PIPING 

MATERIAL 

, 

YRCP 

INSTALLED 

UST SITE PLAN - On the back draw a diagram showing the important parts ofthe facility 

(tanks, lines, manway locations, turbines, vents, rectifier, pump islands, buildings), indicate 

reference cell locations where structure-to-soil potential or continuity measurements have been 

made and label(R-1, R-2, R-3); location of all anodes and wires; location of CP test stations. 

March 2008 Page 3 of 5 06-LQ-019A 
Facility Name_ Test Date _Facility #_ 

IIVIPRESSED CURRENT CP TEST RESULTS REPORT PAGE 

RECTIFIER DATA 

RECTIFIER MANUFACTURER: RATED DC OUTPUT: VOLTS AMPS 

RECTIFIER MODEL: RECTIFIER SERIAL NUMBER: 

RECTIFIER OUTPUT AS INITIALLY DESIGNED OR LAST RECOMMENDED (if available): VOLTS • AMPS 

DATE TAP SETTINGS 

Coarse Fine 

DC OUTPUT 

Volts AMPS 

HOUR 

METER COMMENTS 

'As Found" 

"As Left" 

STRUCTURE TO SOIL POTENTIAL MEASUREMENTS 

ID STRUCTURE CONTACT POINT REFERENCE CELL ID ON INSTANT 

OFF 

100MV \ 

NATIVE CHANGE 

CP TEST STATION REQUIREMENTS 

Have previous CP system test records been reviewed? QYesQ No 

Has this CP test been performed consistent with previous CP system 

tests? I I Ye s I I N o 

If test procedures have changed since last test please explain: 

Have potential measurements been made at all tanks and piping including any buried flex-connectors? [ ^Yes [ | No 

COMPLETE IF ANY REPAIRS OR MODIFICATIONS TO THE CP SYSTEM ARE MADE OR ARE NECESSARY 

Complete If any repairs or modifications to the cathodic protection system are made or are necessary. 

1 J Additional anodes for an impressed current system (attach corrosion experts design) 

J Repairs or replacement of rectifier (explain below) 

|: J Anode header cables repaired and/or replaced (explain below) 

Impressed current protected tanks/piping not electrically continuous (explain below) 

Remarks/Other:: 

March 2008 Page 4 of5 06-LQ-019A 
Facility Name_ Test Date _Facility #_ 

GALVANIC (SACRIFICIAL) CP TEST RESULTS REPORT PAGE 

STRUCTURE TO SOIL POTENTIAL MEASUREMENTS 

ID STRUCTURE CONTACT POINT 

-

• 

REFERENCE CELL ID mV COMMENTS 

•• V ' • • 

CP TEST STATION REQUIREMENTS 

Have previous CP system test records been reviewed? Yes No 

Has th s CP test been oerformed consistent with previous CP svstem 

tests? [Yes N o 

If test procedures have changed since last test please explain: 

Have potential measurements been made at all tanks and piping, including any buried flex-connectors? Yes No 

COMPLETE IF ANY REPAIRS OR MODIFICATIONS TO THE CP SYSTEM ARE MADE OR ARE NECESSARY 

Describe any repairs or modifications to the cathodic protection system that are made or are necessary. 

March 2008 Page 5 of5 06-LQ-019A