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SWRCB, January 2002 <br />4. ,TANK ANNULAR TESTING <br />Page �2— of -7 <br />Test Method Developed By: Tattk Manufacturer 17 Industry Standard (J Professional Engineer <br />❑ 61her (Spec) <br />Test Method Used: ❑ Pressure Vacuum ❑ Hydrostatic <br />0 Other (S eco) <br />_ <br />Test Equipment Used: aLt. etttaw f� ,:fr.u6 , 111 140 <br />Tank # z "t.- Tank # <br />Equipment Resolution: rL <br />Tank # / <br />Tank # <br />Is Tank Exempt From Testing?' <br />U Yes o <br />\ ❑ Yes ❑ No <br />❑ Yes Cl No/ <br />❑ Yes ❑ No <br />Tank Capacity: <br />i <br />Tank Material: <br />Tank Manufacturer: <br />Iiia N,, <br />Product Stored: <br />«� tV, <br />Wait time between applying <br />pressure/ acuu ater and <br />starting test: <br />f <br />�� l <br />Test Start Time: <br />Initial Reading (111): <br />Test End Time: <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (Rr-R,): <br />/V' <br />Pass/Fail Threshold or Criteria: <br />N ct Los S rpt p- <br />Test Result: <br />Pass ❑ Fail <br />( pq <br />y° Pass ET�Fail <br />❑t Pass ❑ Rail <br />Was sensor removed for testing? <br />Yes U No ❑ NA <br />Yes ❑ No ❑ NA <br />q/Yes ❑ No '� NA <br />❑ Yes ❑ No ❑ NA <br />Was sensor properly replaced andt <br />verified functional after testin ? <br />>d es ❑ No 11 NA <br />❑ Yes ❑ No ❑ N. � <br />Yes ❑ No ❑'NA <br />❑;Yes ❑ No ❑ NA <br />Comments — (include information on repairs made prior to testing, and recommended follow-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(x)(6)} <br />