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9-0 <br />WRCB; January 2002 <br />Page 'L of _1 <br />hod Developed By: Tank Manufacturer _ ❑ Industry Standard ❑ Professional Engineer <br />❑ Other (Spec) <br />hod Used: ❑ Pressure Vacuum ❑ Hydrostatic <br />❑ Other (Spec) <br />ipment Used: Equipment Resolution: <br />iufL�} t �� �: ,.h�Tank # 1 Tank # 2 Tank #Tankxempt <br />RManufacturer: <br />From Testing?' <br />X Yes No <br />X Yes No <br />❑ Yes ❑No ❑ Yes ❑ Noacity: <br />15K <br />15K <br />terial: <br />Fiberglass <br />Fiberglass <br />nufacturer: <br />XERXES <br />XERXES <br />tored: <br />Regular 87 <br />Supreme 91 <br />Wait time between applying <br />vacuum and starting test: <br />Exempt <br />See Comments <br />Exempt <br />See Comments <br />Test Start Time: <br />Initial Reading (Rj): <br />Test End Time: <br />y <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 ❑ Pass ❑ Fail <br />Was sensor removed for testing? <br />❑ No ❑ NAes <br />❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA ❑ Yes ❑ No DNA— <br />NAWas <br />Was sensor properly replaced and <br />verified functional after testing? I <br />Yes ❑ No ❑ NA <br />Yes ❑ No ❑ NA <br />❑ Yes ❑ No [INA ❑ Yes ❑ No [INA <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 />t 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)1 <br />