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..00, <br /> SWRCB,January 2002 Page of <br /> S. FILL RISER CONTAINMENT SUMP TESTING <br /> Facility is Not Equipped With Fill Riser Containment Sumps X <br /> Fill Riser Containment Sumps are Present,but were Not Tested <br /> Test Method Developed By: ❑Sump Manufacturer E Industry Standard E Professional Engineer <br /> E Other(Specify) <br /> Test Method Used: ❑Pressure Vacuum ❑Hydrostatic <br /> ❑Other(Specify) <br /> Test Equipment Used: Equipment Resolution: <br /> Fill Sum # Fill Sump# Fill Sump# Fill Sump# <br /> Sum7.7t7o <br /> SumDepth: <br /> HeiofHi <br /> Height from Tank Top to Lowest <br /> Electrical Penetration: <br /> Condition of sump prior to <br /> testing: <br /> Portion of Sump Tested <br /> Sump Material: <br /> Wait time between applying <br /> water and starting test: <br /> Test Start Time: <br /> Initial Reading(R,):: <br /> Test End Time: <br /> Final Reading(RF): <br /> Test Duration: <br /> Chane in Reading(R,-R,): <br /> Pass/Fail Threshold or Criteria: <br /> Test Result: ❑Pass E Fail E Pass E Fail ❑Pass ❑Fail ❑ Pass ❑Fail <br /> Is there a sensor in the sump? E Yes E No E Yes U No E Yes E No E Yes C No <br /> Does the sensor alarm when <br /> either product or water is E Yes E No E NA ❑Yes ❑No ENA ❑Yes E No E NA ❑Yes E No ENA <br /> detected? <br /> W as sensor removed for testing? E Yes E No ❑NA E Yes ❑No ENA E Yes E No [INA EYes E No ENA <br /> Was sensor properly replaced and 0 Yes E No ❑NA E Yes ❑No ❑NA E Yes E No ❑NA Yes E No E NA <br /> verified functional after testing? <br /> Comments—(include information on repairs made prior to testing, and recommendedfollow-up forfailed tests) <br />