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SWRC13, January 2002 <br />R_ Fl()I,�, Q)ICF'.Q !'(1NTAINMRNT CIiMP TCCTtI�i!`� <br />Page 1,�- of <br />Facility is Not Equipped With Fill Riser Containment Sums U <br />Fill Riser Containment Sumps are Present, but were Not Tested U <br />Test Method Developed By: U Sump Manufacturer U Industry Standard ,professional Engineer <br />U other (Spec) <br />Test Method Used: U Pressure U Vacuum ><Hydm tatie <br />U Other (Specify) <br />Test Equipment Used.- .A (,j /I Lt w L G % -E:;& e a OK <br />Equipment Resohrtion: l L1-rc <br />Fill Sump # 5—u 5 Fill Sum # <br />Fill Sum # Fill Sum # <br />Surnp Diameter <br />Sum the <br />r) 4 11 <br />Height from Tank Top to Top of <br />Highest Pipilig Penetration: <br />Height from Tank Top to Lowest <br />Electrical Penetration: <br />Condition of sump prior to <br />testing: <br />r <br />Portion of Sump Tested <br />L w4 14311 01 <br />Sump Material: <br />Wait timebetwecn applying <br />pressurelvacu ate <br />starting test <br />IS t�o <br />Test Start Time: <br />o <br />Initial Reading R,): <br />Test End Time: <br />2-! Zp <br />Final Reading RF': <br />&".1-e <br />Test Duration: <br />3 o rh�w t s <br />Change in Reading (RF-R).- <br />RF-R).Pass/Fail <br />Pass/FailThreshold or Criteria: <br />e i V� 3 o r-, r n. <br />''es''JC%suit�,ut ;, <br />Pass 1J Fad : <br />IJ: P U .Fail:. <br />1U . P U. Fail <br />Is there a sensor in the sump?X <br />Yes U No <br />U Yes U No <br />U Y1 s U No <br />U es U No <br />Does the sensor alarm when <br />either product or water is <br />I•� U No U NA <br />U Yes L No U NA <br />U Yes U No U NA <br />U Y U No U NA <br />detected? <br />Was sensor removed for testing? <br />X Yes U No U NA <br />U Yes No U NA <br />U Yes U No U NA <br />U Y U No U NA <br />Was sensor properly replaced and <br />X Yes U No U NA <br />verified functional after testing? <br />U Y U No U NA <br />U Y U No U NA <br />U U No U NA <br />Comments — (include information on repairs made prior 10 testing and recommended follow up or jailed tests) <br />