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Page 2 of 7 <br /> 4. TANK ANNULAR TESTING <br /> Test Method Developed By: ❑Tank Manufacturer ❑Industry Standard C Professional Engineer <br /> ❑0Cher(Specify) <br /> Test Method Used: C Pressure ❑ Vacuum ❑Hydrostatic <br /> No annular space(single wall) 0 Other(Specify) <br /> Test Equipment Used: Equipment Resolution: <br /> Tack# Tank# Tank# Tank# <br /> Is Tank Exempt l~rora Vesting?` n Yes 17 No C Yes ❑No ❑Yes ❑No ❑Yes ID Na <br /> Tank Capacity: <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 Leading(RJ): <br /> Test End Time: <br /> Final Reading(Kr): <br /> Test Duration.: i <br /> Change in Reading(RF-Ri): <br /> Pass/Fail Threshold or Criteria: <br /> 'fest Result: 0 Fars 11-Fail ❑ Pass ❑Fail ❑ Pass ❑Fall ❑ Pass 0 Fail <br /> Was sensor removed for testing? CF Yes .J No C NA C Yes ❑No 1--I NA ❑Yes C}No [INA ❑Yes O No ❑NA <br /> Was sensor properly replaced and Eyes <br /> E No ❑NA ❑Yes O No ❑NA ❑Yes rJ No ❑NA ❑Yes ❑No ENA <br /> verified functional after testing? <br /> Comments--(include information on repairs made prior to teVin and recommended follow-uta f 'ed[est s) <br /> - �r ,/ ,�OT atl <br /> Componer passed previous testing on November 30, 2005 <br /> ' 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. Xalifvrnia Code of Regulations.Title 23,Section 2637(a)(6)1 <br />