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SWRCB, January 2002 RECEIVED <br />S. FILL RISER CONTAINMENT SUMP TESTING D�f96"1 <br />Facility is Not Equipped With Fill Riser Containment Sumps X <br />Fill Riser Containment Sumps are Present, but were Not Tested i <br />Test Method Developed By: C] Sump Manufacturer DEPARTMENT <br />Industry Standard ❑ Professional Engineer <br />—0 Other (Sped) <br />Test Method Used: ❑ Pressure <br />[J Vacuum 11 Hydrostatic <br />❑ Other (Sped) <br />Test Equipment Used: <br />_ } Filly Sump # <br />S1111]p Dian1c'ter: <br />Sum De the <br />Height from Tank Top to Top of <br />Hi hest Pi in Penetration: <br />Height from Tank Top to Lowest <br />Electrical Penetration: <br />Condition of sump prior to <br />testin : <br />Portion of Sura Tested <br />Sum Material: <br />Wait time between applying <br />water and startin test: <br />Test Start Time.- <br />Initial <br />ime:Initial Readin <br />Test End Time: <br />Final Readin (RF): <br />Test Duration: <br />Change in Reading (RF-Rr): <br />Pass/Fail Threshold or Criteria: <br />Test Result: <br />is there a sensor in the sump? <br />Does the sensor alarm when <br />either product or water is <br />detected? <br />Was sensor removed for testin ? <br />Was sensor properly replaced and <br />verified functional after testinO <br />Equipment Resolution: <br />Fill Sump # ["if] Sum # <br />l Fell Sun] ;z <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />