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.y <br />January 2002 Page Z- of <br />4. TANK ANNULAR TESTING <br />Fest Method Developed By: ❑ Tank Manufacturer .,Xndustry Standard ❑ Professional Engineer <br />❑ Other (Specify) <br />Test Method Used: ❑ Pressure J'Vacuum ❑ Hydrostatic <br />❑ Other (Specify) <br />Test Equipment Used: t f <br />Equipment Resolution: &9t <br />Tank '# <br />Tank # <br />Tank # <br />Tank # <br />Is Tank Exempt From Testing?' <br />❑ Yes _No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes f 1 No <br />Tank Capacity: <br />20 14 <br />Tank Material: <br />Tank Manufacturer: <br />Product Stored: <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />Test Start Time: <br />Initial Reading (R1): <br />Test End Time: <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (RF -R1): <br />Pass/Fail Threshold or Criteria: <br />Test Result: <br />Pass ❑ Fail <br />❑ .Pass ❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />Was sensor removed for testing? <br />Q'Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />Was sensor properly replaced and <br />verified functional after testin ? <br />dYes El No El NA <br />❑ Yes El No ❑ NA <br />[I Yes El No [INA <br />❑ Yes ❑ No ❑ NA <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />1 Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary <br />containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment <br />testing. (California Code of Regulations, Title 23, Section 2637(a)(6)) <br />