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SWRCB. January 2002 <br />/.unju K-I11aYL+nNEK11U1V1Al1V1VIEIN1IU1)U)1'hS'1'1.NG <br />Page 5 of <br />Test Method Developed By: [ ] UDC 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 />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />NO UDC AT THIS SITE <br />1 If the entire depth of the UDC is not tested, specify how much was tested. If the answer to any of the questions indicated with an asterisk (*) is "NO" or <br />"NA", the entire sump must be tested. (SWRCB LG -160) <br />UDC # <br />UDC # <br />UDC # <br />UDC # <br />UDC Manufacturer: <br />UDC Material: <br />UDC Depth: <br />Height from UDC Bottom to Top <br />of Highest Piping Penetration: <br />Height from UDC Bottom to <br />Lowest Electrical Penetration: <br />Condition of UDC prior to <br />testing: <br />Portion of UDC Tested 1 <br />Does turbine shut down when <br />UDC sensor detects liquid <br />(both product & water)? <br />[ ] Yes [ ] No [ ] NA <br />( ] Yes [ ] No [ ] NA <br />[ ] YES [ ] NO [ ] NA <br />[ ] YES [ ] NO [ ] NA <br />Turbine shutdown response <br />time: <br />Is system programmed for <br />fail-safe shutdown? <br />[ ] YES [ ] NO [ ] NA <br />[ ] YES[ ] NO [ ] NA <br />[ ] YES [ ] NO [ ] NA <br />[ ] YES [ ] NO [ ] NA <br />Was fail-safe verified to be <br />operational? <br />[ ] YES [ ] NO [ ] NA <br />[ ] YES [ ] NO [ ] NA <br />[ ] YES [ ]NO[ ] NA <br />[ ] YES [ ]NO[ ] NA <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />Test Start Time: <br />Initial Reading (Rl): <br />Test End Time: <br />Final Reading (Rf): <br />Test Duration: <br />Change in Reading (Rf-R1) <br />Pass/Fail Threshold or <br />Criteria: <br />Test Result; <br />I I Pass Fail <br />1, 1 Pass I I>Fail <br />Pass L I Fail <br />Pass Fail <br />Was sensor removed for testing? <br />Yes No N/A <br />Yes No N/A <br />Yes No N/A <br />Yes No N/A <br />Was sensor properly replaced <br />and verified functional after <br />testing? <br />[ ] Yes [ ] No [ ] N/A <br />[ ] Yes [ ] No [ ]N/A <br />[ ) Yes [ ]No[ ]N/A <br />[ ] Yes [ ]No[ ] N/A <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />NO UDC AT THIS SITE <br />1 If the entire depth of the UDC is not tested, specify how much was tested. If the answer to any of the questions indicated with an asterisk (*) is "NO" or <br />"NA", the entire sump must be tested. (SWRCB LG -160) <br />