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0 0 <br />SWRCB, January 2002 FINAL DRAFT <br />17 Vn l[ . R]rCTR irnNTAiNMF.NT CIiMP TESTING <br />Page 6 of 7 <br />Facility is Not Equipped With Fill Riser Containment Sump(s) <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 (Specify <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 (RO: <br />Test End Time: <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (RF -RI): <br />Pass/Fail Threshold or Criteria: <br />Test Result <br />Is there a sensor in the sump? <br />HPassOF—an <br />Yes No <br />Pass Fail <br />Yes ONo <br />FlPass Fail <br />OYes ❑No <br />Pass OFail <br />Yes No <br />Does the sensor alarm when <br />either product or water is <br />detected? <br />Was sensor removed for testing? <br />❑Yes [:]No [:INA <br />Yes No NA <br />❑Yes ❑No [:INA <br />OYes ONo NA <br />❑Yes ❑No ❑NA <br />Yes No EINA <br />❑Yes ❑No ❑NA <br />Dyes No EINA <br />Was sensor properly replaced and <br />verified functional after testing? <br />❑yes ❑No ❑NA <br />❑Yes [:]No [INA <br />❑Yes [:]No [:INA <br />❑Yes [:]No [:INA <br />Comments — (Include information on repairs made prior to testing, and recommended follow up for failed tests.) <br />No fill riser containment sumps. <br />