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FILL RISER CONTAINMENT SUMP TESTING <br />Facility is Not Equipped With Fill Riser Containment Sumps <br />Fill Riser Containment Sumps are Present, but were Not Tested ❑ <br />Test Method Developed By: ❑ Sump Manufacturer ❑ Industry Standard ❑ Professional Engineer <br />❑ Other (Specify) <br />Test Method Used: ❑ Pressure ❑ vacuum ❑ Hydrostatic <br />❑ Other (Spec) <br />Test Equipment Used: <br />Equipment Resolution: <br />Fill Sump # <br />Fill Sump # <br />Fill Sump # <br />Fill Sump # <br />Sump Diameter: <br />Sump Depth: <br />Height from Tank Top to Top of <br />Highest Piping Penetration: <br />Height from Tank Top to Lowest <br />Electrical Penetration: <br />Condition of sump prior to <br />testing: <br />Portion of Sump Tested <br />Sump Material: <br />Wait time between applying <br />pressure/vacuum/water and <br />starting 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-Rj): <br />Pass/Fail Threshold or Criteria: <br />Test Result: <br />El Pass El Fail <br />El Pass El Fail <br />El Pass El Fail <br />0 Pass Fail <br />Is there a sensor in the sump? <br />Yes No <br />Yes No <br />Yes No <br />LJYes LjNo <br />Does the sensor alarm when <br />either product or water is <br />detected? <br />❑Yes ❑No ❑N/A <br />❑Yes ❑No [-]N/A <br />❑Yes [-]No ❑N/A <br />❑Yes [-]No ❑N/A <br />Was sensor removed for testing? <br />Yes LJNo N/A <br />Yes No N/A <br />LJYes LJNo N/A <br />LJYes LJNo N/A <br />Was sensor properly replaced and <br />verified functional after testinj <br />Yes ONo N/A <br />Yes No N/A <br />Yes No N/A <br />LJYes No N/A <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />