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4' TANK ANNULAR TESTING <br />Test Method Developed By: ❑ Tank Manufacturer <br />® Industry Standard ❑Professional Engineer <br />❑ Other (Spec) <br />Test Method Used: ❑ Pressure <br />® Vacuum El Hydrostatic <br />❑ Other (Specify) <br />Test Equipment Used; Test plugs, venturi pump and gauges <br />} ° Equipment Resolution: 0.5% of span <br />Tank #�-� ' Tank #043- ' t <br />Tank # Tanli # <br />Is Tank Exempt From Testing?' ❑ Yes SoNo <br />❑ Yes No ❑Yes <br />Tanl< Capacity; ❑ No 11 Yes El No <br />,^� <br />I ank Material: <br />Tanl< Manufacturer: <br />Product Stored: <br />Wait time between applying <br />pressure/vacuum/water and <br />star in test: <br />Test Start Time: <br />Initial Reading (R,): <br />Test End Time: <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (RF <br />Pass/Fail Threshold or Criteria: <br />Test Result: <br />Was sensor removed for testing? <br />Was sensor properly replaced and <br />verified functional after testinE? <br />%p til l t✓ <br />g�,c <br />2!!!•, <br />f�i UYt i° <br />1 UYyei <br />No detectable Loss <br />No detectable Loss <br />No detectable Loss <br />No detectable Loss <br />,l Pass ❑ Fail <br />i� Pass Cl Fail <br />❑ Pass ❑ Fail <br />D Pass ❑Fail <br />❑ Yes No SNA <br />❑ Yes-,E3,No ,Q NA <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No AWA <br />❑ Yes ❑ No JAMA <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />Comments (include ii formation on re airs made prior to testing, and recommended <br />L <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)1 <br />