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FROM :Donlee pump co. FAX NO. :2095379398 ',t9. 29 2005 09:12AM P4 <br />S�vRC6.11, uaty 2002 <br />4. TANK ANNULAR TF -STING <br />Past: L of 1�- <br />Test Method Developed By: a Tank Manufacturer 0 Industry Stallditrd 11 Professional Engineer <br />Q Other (Spec6) <br />Test i\Ietllod Used -0 Pressure acuutn ❑ Hydrostatic <br />t it Other (Specify) <br />Equipment Used: <br />Equipment Resolution: <br />iTcs1 <br />a <br />Tank #(L Tanit #. t,, L <br />Tank # Tank # <br />Is Tank Exempt From Testing?I Q Yes o C Yes C No <br />C Yes Q No <br />Q Ycs C No <br />Trull. Capacity: <br />ac, 0 <br />Tank, Adanufacturer: lj LL? A I! 5MV4 <br />61talyt " , - <br />Product Stored: f <br />Wait tine between applying <br />presslire%;tcuum/«•ater and <br />starting test: <br />Test Stan Time: ^ r� <br />V ; y <br />Initial Reading (R): <br />►N <br />Tcst End Time: �� <br />y <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (RF -RI): <br />Pass, ail Threshold or Criteria: � <a <br />Test Result'i ❑ Fail <br />vpass ❑ Fail <br />❑ Pass 0 Fail <br />0 Pass ❑ Fail <br />Was sensor removed for testing? es C No Q NA <br />, 'cs ;: No C NA <br />G Ycs ::,No CNA <br />G Yes C No CNA <br />Was sensor properly replaced and 2/ <br />yes <br />'cs <br />lied functional after testing'' �dYes No CNA <br />= No C NA <br />C Yes is No C NA <br />C Yes Q No C NA <br />C0f11111 of (S — (include infurina ion an re airs nrnrle prior lv les ir7L,, mTd Yc�CynurtelrGlNrl fvllvlr-!rp yr frlljt�c! lrshj <br />' Sccond;tq' contaimllent systems where tllc continuous monitoring atltonl:)tica11), monitors both the pdmat)' and second 1n• <br />Coll t.Ii11111eitt, such as vstems that are hydrostalic;11h• utouitored or under consiant VVICIItIm, arc exempt from periodic conloinntcnt <br />(Cidifontla Code of Rcgulations, Title 23, Scctiot12617(a)(6)� <br />