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SWRCB,January 2002 • Page Z Of <br /> 4. TANK ANNULAR TESTING <br /> Test Method Developed By: ❑Tank Manufacturer 91ndustry Standard ❑Professional Engineer <br /> ❑Other(Specify) <br /> Test Method Used: ❑Pressure B'Vacuum ❑Hydrostatic <br /> ❑Other(Specify) <br /> Test Equipment Used: M F/ D": Equipment Resolution: <br /> Tank# /(NLp Tank# &1j'-- Tank# G!/.Q Tank# <br /> Is Tank Exempt From Testing?' ❑Yes VINO ❑Yes VNo ❑Yes VNO ❑Yes ❑No <br /> Tank Capacity: (;Au- v /Q "0 0064KLGv1/ <br /> Tank Material: <br /> Tank Manufacturer: F✓i�N <br /> Product Stored: lr/ <br /> Wait time between applying <br /> pressure/vacuum/water and <br /> starting test: /Q ykt�/ /Q7U /� lstl•� <br /> Test Start Time: / 0 : 30 <br /> Initial Reading(RD: 7-0tQ • Q'F <br /> Test End Time: 1( ;3r S <br /> Final Reading(RF): n <br /> Test Duration: 171 <br /> Change in Reading(RF-RO: (�— <br /> Pass/Fail Threshold or Criteria: 5,3 r' H"g 5,.3" f fa tr ,S " p&V <br /> Test Result: VPass ❑Fail RKPass ❑Fail brpass ❑Fap ❑ Pass D Fail <br /> Was sensor removed for testing? UYYes ❑No ❑NA V'fes ❑No [INA o3'I'es ❑No [INA ❑Yes ❑No ❑NA <br /> Was sensor properly replaced and <br /> verified functional after testing! V 1'es ❑No ❑NA VX Ies []No ❑NA Vies ❑No ❑NA ❑Yes ❑No [INA <br /> Comments— (include information on repairs made prior to testing and recommended ollow-up for failed tests) <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. {California Code of Regulations,Title 23, Section 2637(a)(6)} <br />