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Nov 12 09 04:55p 209- 67-5424 p.3 <br /> SWRCB,January 2002 Page_.:L of <br /> 4. TANK ANNULAR TESTING <br /> Test Method Developed By: ❑Tank Manufacturer ❑Industry Standard ❑Professional Engineer <br /> ❑Other(Specify) <br /> Test Method Used: C Pressure ❑Vacuum ❑Hydrostatic <br /> C Other(Specify) <br /> Test Equipment Used: EquipmenyResolution: <br /> Tank# Tank# Tank Tank# <br /> Is Tank Exempt From Testing?' ❑Yes ❑NO G Yes ❑No ❑ es. ❑No C Yes ❑No <br /> Tank Capacity: <br /> Tank Material: <br /> Tank Manufacturer. ti <br /> Product Stored: <br /> Wait time between applying <br /> pressure/vacuum/water and <br /> starting test: <br /> Test Start Time: i <br /> Initial Reading(R,): i <br /> Test End Time: <br /> Final Reading(RF): <br /> Test Duration: <br /> Change in Reading(RF-R,): <br /> Passlf ail Threshold or Criteria: <br /> Tdst:Result= ❑ 'pass it,-, ® ass NFail D Pass ❑Fail . E D Pm, l] ail <br /> Was sensor removed for testing? ❑Yes END A ❑ ❑No NA ❑Yes ❑No ®NA ❑Yes ❑No O NA <br /> Was sensor properly replaced and ❑Yes C N o C ❑Yes ❑No ❑ A ❑Yes ❑No ❑NA j D Yes ❑No CNA <br /> verified functional after testing? <br /> Comments—(include information on repairs ade prior t testing and recommended ollow-u or failed tests) <br /> ll <br /> 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. Kalifornia Code of Regulations,Title 23,Section 2637(ax6)) <br />