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C <br />-- <br />S. FILL RISER CONTAOMFNT RUMP TF.CTTNC- <br />Facility is Not Equipped With Fill Riser Containment Sumps~ `.4 v — <br />Fill Riser Containment Sumps are Present, but were Not Tested ❑ <br />Test Method Developed By: ❑ Sump Manufacturer D Industry Standard ❑ Professional Engineer <br />0 Other (Speci& <br />Test Method Used: O Pressure <br />O Other (Specify) <br />❑ Vacuum <br />(✓�Hydrostatic <br />Equipment Resolution: <br />Fill Sump # <br />----------- <br />Test Equipment Used: <br />Fill Sump # <br />Sum Diameter: <br />Sump Depth: <br />Height from Tank Top to Top of <br />Highest Piping Penetration: <br />Fill Sump # <br />Fill Sump # <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 />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />Test Start Time: <br />Initial Reading (RI): <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: 0 Pass ❑ Fail <br />Is there a sensor in the sump? O Yes ❑ No <br />Does the sensor alarm when either <br />product or water is detected? O Yes O No DNA <br />0 Pass ❑ Fail . <br />O Yes O No <br />O Yes O No DNA <br />❑ Pass ❑ Fail <br />0 Pass ❑ Fail <br />O Yes O No <br />O Yes O No <br />0 Yes O No O NA <br />0 Yes 0 No O NA <br />Was sensor removed for testing? O Yes O No DNA <br />Was sensor properly replaced and <br />verified functional after testing? ❑ Yes O No DNA <br />❑ Yes ❑ No ❑ NA <br />O Yes O No DNA <br />O Yes ❑ No 0 NA <br />O Yes O No O NA <br />O Yes O No O NA <br />O Yes O No DNA <br />Comments — (include information on repairs made prior 10.1esting, and recommended follow up fof failed tests) <br />