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Secondary Containment Testing Report Form-Page 3 of S <br /> F. Testing of Piping Sumps/Turbine Sumps ❑N/A(No pipitig/turbine sumps) <br /> Test Method Developed By: ❑Sump Manufacturer;[]Industry Standard; E;❑Other(Specify): <br /> Test Method Used:. a Pressure; ❑Vacuum; 'Hydrostatic; 0 Other(Sped): <br /> Test Equipment Used: Equipment Resolution: <br /> z _ Sump#: Sump#: 61Sump#: Sump#: <br /> Sump Diameter(inches): &n <br /> Sump Depth(inches): H14« ii <br /> Sump Material: <br /> Height from Tank Top to Top of ��« <br /> Highest Pipe Penetration(inches): Z q le <br /> Height from Tank Top to Lowest All <br /> Electrical Penetration(inches): or, _1(r <br /> Portion of Sump Tested: Per, <br /> If turbine shuts down when sump VWUA p N/A ❑N/A <br /> sensor detects liquid,specify minutes. minutes. minutes. minutes. <br /> turbine shutdown response time. <br /> Wait time between applying <br /> pressure/vacuurn/water and ?�t) minutes. 56 minutes, minutes. minutes. <br /> start!!! test: <br /> Test Start Date/Time: P we 10,01, u <br /> Initial Reading(Rj): .7-14005 fo,('25" <br /> Test End Date/Time: :LA® <br /> F nal Reading(Rp): !o•to2�l <br /> Change in Reading(RF--Rj): 0.wtoo o.eav�CD <br /> Pass/Fail Threshold or Criteria: 0•b07-00 0.001.00 <br /> ']Gest Result: ZPass; ❑Fail -Pass; ❑Fail ❑Pass; ❑Fail ❑Pass; ❑Fail <br /> Was leak detection sensor <br /> properly replaced and verified as 9—yes;❑No; 'Yes;El No; ❑Yes;El No; E]Yes;El No; <br /> functional after testing? EJN/A(Not Removed) ElN/A(Not Removed) ❑N/A(Not Removed) ❑N/A(trot Removed) <br /> G. Testing of Under-Dispenser Containment (UDC) ❑N/A(No dispensers or no UDC) <br /> Test Method Developed By: ❑UDC Manufacturer;❑Industry Standard; E;❑Other(Specify): <br /> Test Method Used: ❑Pressure; ❑Vacuum;�-Hydrostatic; ❑Other(Spec): <br /> Test Equipment Used: Equipment Resolution: <br /> y <br /> 2017 <br /> E VIRON IvIIENTAL. HEALTH <br /> ; P TimEN <br /> UN-054-3/5 wfnv.unidoes.org 02125/02 <br />