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RECEIVEE) <br /> SWRCB,January 2002 '1Page,of_ <br /> S. FILL RISER CONTAINMENT SUMP TESTING 1OA' <br /> Facility is Not TTuipped With Fill Riser Containment Sumps <br /> Fill Riser Containment Sumps are Present,but were Not Tested C"' IR N <br /> Test Method Developed By: 0 Sump Manufacturer _!Industry Standard U Prof H <br /> U Other(Spec) <br /> Test Method Used: D Pressure U Vacuum U Hydrostatic <br /> G Other(Spec) <br /> Test Equipment Used: Equipment Resolution: <br /> Fill Sump# Fill Sump# Fill Sump# Fill Sump# <br /> Sum Diameter: <br /> Sump D th: <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 /> Surnp 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-111): <br /> Pass/Fail Threshold or Criteria: _ <br /> Test Result: L Pass 0 FailPass 7 Fail Pass C Fail ❑.Paas ( Fail <br /> Is there a sensor in the sump? 1:. Yes C No ❑Yes U No U Yes U No ❑Yes U No <br /> Does the sensor alarm when U Yes U No ❑NA <br /> either product or water is U Yes U No U NA U Yes :a No U NA 1'.1 Yes F;No U NA <br /> detected? <br /> Was sensor removed for testing? U Yes U No U NA U Yes U No U NA U Yes U No U NA C:Yes C.No U NA <br /> Was sensor properly replaced and I::: Yes U No I::1 NA <br /> verified functional after testing? ❑Yes U No DNA 171 Yes i No U NA U Yes 1'..jNo O NA <br /> Comments—(include information on repairs made prior to testing,and recommended follow-up for failed tests) <br />