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S W PC'13, January 2002 <br />8. FILL RISER CONTAUVWNT SIJ1" TESTING <br />Page 7 of <br />ii s <br />=PiFacility is Equipped With Fill Riser Containment Sumps 0 <br />I 1 01 <br />Fill C <br />illP-seir Containment Sumps are Present, but were Not Tested <br />, <br />Test MedW-4,Developed By: o Sump Manufacturer. 0 Industry Standard 0 Professional Engineer <br />13 Other (Specify) <br />Test Method Used: 0 Pressure 0 Vacuum 0 Hydrostatic <br />0 Other (Specify) <br />Test Equipment Used: <br />Equipment Resolution: <br />Fill Sum # <br />Fill Sum e # <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 />Portion of Sump Tested <br />Sump Material: <br />Wait time between applying <br />pressure/vacuum/water and <br />startinF, test: <br />Test Start Time: <br />Initial R6ading (KO, <br />Test End Time: <br />Final Reading (KF): <br />Test Duration: <br />Change in Reading (RF-Rj):, <br />Pass/Fail Threshold or Criteria: <br />Test Result: 0 Pass 0 Fail <br />0 Pass 0 Fail <br />0 Pass 0 Fail <br />0 Pass 0 Fail <br />Is there- a sensor in the sump? 0 Yes 0 No <br />0 Yes 0 No <br />0 Yes 0 NO <br />d Yes 0 No <br />Does the -sensor alarm when <br />either product or water is DYes ONo DNA <br />detect&d'? <br />DYes ONo [INA <br />0 Yes 0 No 0 NA <br />0 Yes 0 No 0 NA <br />Was sensor removedfor testing? DYes, ONo, DNA. <br />OYes, ONo DNA. <br />DYes ONO EINA- <br />0 Yes, 0No- DNA <br />Was sensor properly replaced and DYes ONo DNA <br />verified functional after testing? I <br />0Yes DNo0NA <br />I <br />DYes DNo DNA <br />0 Yes DNo DNA <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />