Get Al Adem 484 2010-2026

The AL ADEM 484 form is essential for submitting tightness test data and results to the Department. Completing this form accurately is crucial for ensuring that your submission is accepted and processed efficiently.

Follow the steps to complete the AL ADEM 484 form online.

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin by entering the Facility ID in the designated field. This unique identifier is necessary for the Department to track your submission.
3. Fill in the Facility Name, Facility Address, and Owner Name accurately. This information helps verify the testing location and ownership.
4. Input the Owner Phone Number for contact purposes, ensuring it is up to date.
5. Enter the Testing Company Name along with their Phone Number to provide details about the entity conducting the test.
6. Complete the fields for the Person Performing Test and their Certification Number, ensuring the credentials are valid.
7. Specify the Tester Certification Expiration Date to confirm the testing personnel's qualifications at the time of the test.
8. List the Manufacturer of Test Equipment along with its Model or Version, referring to the National Work Group List for compliance.
9. Circle all applicable reasons for the test in the 'Reason for Test' section, ensuring multiple reasons can be identified.
10. For each Unique Tank Number (up to six), specify the details of the substance stored, ensuring clarity and accuracy.
11. Fill out the Date of Test, Tank Size in gallons, and the percentage full during the test.
12. Provide the Equipment Threshold and the Measured Leak Rate, marking whether the test result is Pass, Fail, or Inconclusive.
13. Report the Groundwater Level, measured above the bottom of the tank, to ensure compliance with testing standards.
14. Sign and date the form, certifying the accuracy of the information provided under penalty of law.
15. Finally, review all entries for completeness before saving changes, downloading, printing, or sharing the form as necessary.

Complete your AL ADEM 484 form online to ensure regulatory compliance.