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SWRCB. January 2002 <br />Page 2 of 7 <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: Equipment Resolution: <br />Tank # <br />Tank # <br />Tank # <br />Is Tank Exempt From <br />Testing? 1 <br />[ ] Yes [ ] No <br />[ ] Yes [ ] No <br />[ ] Yes [ ] No <br />Tank Capacity: <br />Tank Material: <br />Tank Manufacturer: <br />Product Stored: <br />Wait time between <br />applying <br />pressure/vacuum/water <br />and starting test: <br />Test Start Time: <br />Initial Reading (Rl): <br />Test End Time: <br />Final Reading (Ri): <br />Test Duration: <br />Change in Reading (Rf- <br />R1 <br />Pass/Fail Threshold or <br />Criteria: <br />Test Result: <br />I 1 PASS [ ] ' FAIL <br />[ ] PASS [ ]FAIL <br />[ 1 PASS [ ] FAIL <br />Was sensor removed for <br />testing? <br />[ ] YES [ ] NO <br />[ ] N/A <br />[ ]YES [ ] NO <br />[ ] N/A <br />[ ] YES [ ] NO <br />[ ] N/A <br />Was sensor properly <br />replaced & verified <br />functional after testing? <br />[ ] YES [ ] NO <br />[ ] N/A <br />[ ] YES [ ] NO <br />[ ] N/A <br />[ ] YES [ ] NO <br />[ ] N/A <br />Comments — (include information on repairs made prior to testing, <br />and recommended follow-up <br />for failed tests) <br />I Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such as systems <br />that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment testing. {California Code of Regulations, Title 23, <br />Section 2637(a)(6)) <br />