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TEST NO. 1- FILL RISER CONT NT 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: <br />❑ Sump Manufacturer <br />❑ Other (Spec) <br />® Industry Standard ❑ Professional Engineer <br />Test Method Used: <br />❑ Pressure <br />❑ Other (Spec) <br />❑ Vacuum <br />0 Hydrostatic <br />Test Equipment Used: Incon Tester <br />Equipment Resolution: <br />Fill Sump #87-1 <br />Fill Sump #87-2 <br />Fill Sump #87-3 <br />Fill Sump #91 <br />Sump Diameter: XXX <br />Sump Depth: XXX <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 />Fiberglass <br />Fiberglass <br />Fiberglass <br />Fiber lass <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: Per Protocol <br />Test Start Time: <br />3:39pm <br />3:39pm <br />3:39pm <br />3:39pm <br />Initial Reading (RI): <br />1.5536 <br />3.4896 <br />2.6002 <br />2.5703 <br />Test End Time: <br />3:54pm <br />3:54pm <br />3:54pm <br />3:54pm <br />Final Reading F): <br />1.5547 <br />3.4891 <br />2.6003 <br />2.5717 <br />Test Duration: <br />15 min. <br />15 min. <br />15 min. <br />15 min. <br />Change in Reading (RF -RI): <br />+.0011 <br />-.0005 <br />+.0001 <br />+.0014 <br />Pass/Fail Threshold or Criteria: <br />3rdParty Certified <br />3 Id Party Certified <br />3' Party Certified <br />3rdParty Certified <br />Test Result: <br />' D Pass ❑Fail <br />®Pass' ❑ Fail <br />D Pass ❑ Fail <br />„. <br />ID -Pass: ❑ Fail <br />Is there a sensor in the sump? <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />® Yes ❑ No <br />Does the sensor alarm when <br />either product or water is <br />detected? <br />❑Yes ❑No DNA <br />❑Yes ❑No DNA <br />❑Yes ❑No DNA <br />❑Yes ❑No DNA <br />Was sensor removed for testing? <br />❑ Yes ❑No DNA <br />❑ Yes ❑ No DNA <br />❑Yes ❑ No ❑ NA <br />❑ Yes ❑ No DNA <br />Was sensor properly replaced and <br />verified functional after testing? <br />❑ Yes ❑No DNA <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No DNA <br />❑ Yes ❑ No DNA <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />