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SWRCB, January 2002 <br />ti <br />0 0 Page of <br />4. TANK ANNULAR TESTING <br />Test Method Developed By: Tank 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 />No= Tank # 1 <br />Tank # 2 <br />Tank # <br />Tank # <br />Is Tank Exempt From Testing?' X Yes No <br />X Yes No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Tank Capacity: 15K <br />15K <br />Tank Material: Fiberglass <br />Fiberglass <br />Tank Manufacturer: XERXES <br />XERXES <br />Product Stored: Regular 87 <br />Supreme 91 <br />Wait time between applying Exempt <br />vacuum and starting test: See Comments <br />Exempt <br />See Comments <br />Test Start Time: <br />Initial Reading (Rj): <br />Test End Time: <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (RF -R,): <br />Pass/Fail Threshold or Criteria: <br />Test Result: <br />Pass ❑ Fail <br />Pass ❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />Was sensor removed for testing? <br />Yes ❑ No ❑ NA <br />Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No [INA <br />Was sensor properly replaced and <br />verified functional after testing? <br />Yes ❑ No ❑ NA <br />Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />Tanks have brine filled Annulars, and are exempt from periodic Testing.! <br />1 Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary <br />containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment <br />testing. {California Code of Regulations, Title 23, Section 2637(a)(6)) <br />