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S WRCB,January 2002 <br /> Page_of_ <br /> 4. TANK ANNULAR TESTING <br /> Test Method Developed By: im Manufacturer C Industry Standard O Professional Engineer <br /> 0 Other(Specify) <br /> Test Method Used: 0 Pressure acuum 0 Hydrostatic <br /> 0 Other(Spew) <br /> Test Equipment Used•. Equipment I <br /> Tank# Tank# Tank# <br /> - Teak# <br /> Is Tank Exempt From Testing' ❑Yes N0 0 Yes ❑No 0 Yes 0 No 0 Yes 0 No <br /> Tank Capacity: <br /> Tank Material: <br /> Tank Manuil entren <br /> Product Stored: <br /> Wait time between applying <br /> Pressurelvacuum/water and t— <br /> stanin test: ryl�n <br /> Test Stan Tine: <br /> Initial Reading(Rt): <br /> Test End Time: <br /> Final Reading(Rr): <br /> Test Duration: <br /> Change in Reading(RF R,): -- <br /> Pass/Fail Threshold or Criteria: ,��' <br /> Test Result Pass 0 Fail 0 Pass 0 Fail 0 Pau 0 Fail 0 Pass 0 Fail <br /> Was sensor removed for testing? 0-fes 0No nNA nYes r ❑NA ❑Yes 0N 11NA GYes ONO [INA <br /> Was sensor properly replaced and fl'i'es ONO DNA Oyes ONO ❑NA ❑Yes ❑No ❑1VA ❑Yes ❑No ❑NA <br /> verified funaionai after testtn ? <br /> Comments— (include information on repairs made prior to tejffS& and recommended follow-up for failed teats) <br /> 'Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary <br /> colitaintnent,such as systems that are hydrostatically monitored or under constant vacuum,ate exempt from periodic containmmt <br /> r,.,r,.nrnnmJntinnc Titin 91 Cnr+inn )rj7/alt6\L <br /> z 'd SiPELLd69T6 uo-4sn <br /> y y4za>1 eET : IT 90 10 nou <br />