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SWRCB,January 2002 Page_of 7. UNDER-DISPENSER CONTAINMENT C TESTING Test Method Developed By: ❑UDC Manufacturer ❑Industry Standard ❑Professional Engineer ❑Other(Spec) Test Method Used: ❑Pressure ❑Vacuum ❑Hydrostatic ❑Other(Spec) Test Equipment Used: Equipment Resolution: UDC# UDC# UDC# UDC# UDC Manufacturer: UDC Material: UDC Depth: Height from UDC Bottom to Top of Highest Piping Penetration: Height from UDC Bottom to Lowest Electrical Penetration: Condition of UDC prior to testing: Portion of UDC Tested' Does turbine shut down when UDC sensor detects liquid(both C Yes ❑No ❑NA ❑Yes ❑No [INA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA product and water)?' Turbine shutdown response time Is system programmed for fail- safe shutdown?' ❑Yes ❑No ❑NA ❑Yes ❑No [INA ❑Yes ❑No ❑NA ❑Yes L1No ❑NA Was fail-safe verified to be o eon ❑yes ❑No [INA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA L1 Yes ❑No 11 NA ratial?' Wait time between applying pressure/vacuum/water and starting test Test Start Time: Initial Reading(R,): Test End Time: Final Reading(RF): Test Duration: Change in Reading(RF-Ri): Pass/Fail Threshold or Criteria: Test Result: ❑ Pass ❑Fail ❑ Pass ❑Fail ❑ Pass ❑Fail ❑ Pass ❑Fail Was sensor removed for testing? ❑Yes ❑No ONAI ❑Yes []No ❑NA ❑Yes ❑No [INA ❑Yes ❑No ❑NA Was sensor properly replaced and ❑yes ❑No ❑NA ❑Yes []No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA verified functional after testing? Comments— (include information on repairs made prior to testing, and recommended follow-up for failed tests) HEALTH If the entire depth of the UDC is not tested,specify how much was tested. If the answer to any of the questions indicated with an asterisk(*)is"NO"or"NA",the entire UDC must be tested. (See SWRCB LG-160)