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S W RCB, January 2002 to <br />0 Page I of *] _ <br />Facility is Not Equipped With Spill/Overfill Containment Boxes ❑ <br />_ <br />Spill/Overfill Containment Boxes are Present, but were Not Tested X <br />Test Method Developed By: ❑ Spill Bucket Manufacturer ❑ Industry Standard ❑ Professional Engineer <br />❑ Other (Spec) <br />Test Method Used: ❑ Pressure ❑ Vacuum ❑ Hydrostatic <br />❑ Other (Spec) <br />Test Equipment Used: <br />Equipment Resolution: <br />x�r Spill Box # Spill Box # <br />Spill Box # Spill Box # <br />Bucket Diameter: <br />Bucket Depth. <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />Test Start Time: <br />Initial Reading (111): <br />Test End Time: <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (RF-Rj): <br />Pass/Fail Threshold or <br />Criteria: <br />Test Result: <br />❑ Pass ❑ Fail ❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />