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Secondary Containment Testing Report Form - Page 5 of 5 <br />Pass/Fail Threshold or Criteria: <br />Bucket <br />_Cj_P_ass­,_0 <br />Test Result: <br />D pass; L Fail <br />Fail E] Pass; 0 F <br />0 Pass; E] ail <br />Fail <br />leakWas detection sensor <br />M Yes; F] NO;❑ <br />Yes; M No; ❑ Yes; [:1 No; <br />El Yes; El No; <br />properly replaced and verified as <br />M N/A (Not Removed) <br />❑ N/A (Not Removed) E] N/A (Not Removed) <br />El N/A (Not Removed) <br />functional after testin, <br />I. Testing of Spill Buckets <br />E N/A (No spill buckets installed) <br />❑ Spill bucket(s) not tested <br />Test Method Developed By: F <br />Bucket manufacturer; E] Industry Standard; L1 PE; ❑ Other (Sped): <br />Test Method Used: D Pressure; El vacuum; ❑ Hydrostatic; [] Other (Specify <br />. . . . ....... <br />Equipment Resolution: <br />Test Equipment Used: <br />- ---- -- --- <br />Bucket 4:Bucket <br />Bucket 4: <br />Bucket <br />Bucket Diameter <br />Bucket Depth: <br />Wait Wait time between applying <br />ressure/vac um/water and <br />pressure/vacuum/water <br />p s <br />rt test: <br />11 Test Start Time: <br />Initial Reading (Rt): <br />-1'cst End Time: <br />Final Reading (RF): <br />. ......... <br />Change in Reading (RF — RO: <br />. .... <br />..... ..... ............. <br />PassiFail Threshold or Criteria: <br />_fesiResult': <br />❑ P Fail <br />Pass; Fail <br />❑Pass; Fail <br />E=] P=ass; =[D]Fail] <br />J. Additional Information <br />Were any repairs made to secondary containment systems prior to testing? E] Yes (describe in "Comments"); Z No <br />Were any secondary containment systems unable to be tested? [] Yes (describe in "Comments"); Z No <br />Is any follow-up action recommended? Z Yes (describe in "Comments"); El No <br />Was any cleaning of secondary containment systems done? n Yes (describe management of wastewater in "Comments" Z No <br />If hydrostatic testing was performed, describe in "Comments" what was done with the water after completion of testing. <br />Comments: Pumped water into tank for reuse <br />VN -054 - 515 NN n «.Unidocs.ory <br />