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Pi <br />0 Page 2 of <br />Chevron # 201383 <br />1960 W. 11 Street <br />Tracy, CA 95387 <br />N05203 -SB 989 Tessin <br />' Secondary containment systems where the w,iti„uvu� ..,.,,,.t.,_.,.� u��.,===u=., u.===. _.=..,.s 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)) <br />4. TANK ANNULAR TESTING <br />Test Method Developed By: <br />❑ Tank Manufacturer N Industry Standard ❑ Professional Engineer <br />❑ Other (Specify) <br />Test Method Used: <br />❑ Pressure <br />❑ Other (Specify) <br />® Vacuum <br />❑ Hydrostatic <br />Test Equipment Used: DIAL GAUGE <br />Equipment Resolution: 0 to 15" Hg Vacuum <br />Is Tank Exempt From Testing?' <br />Tank # i <br />❑ Yes ❑ No <br />Tank # T 4 <br />❑ Yes ❑ No <br />Tank # g t Tank # <br />❑ Yes ❑ No ❑ Yes ❑ No <br />Tank Capacity: <br />GALLONS <br />GALLONS <br />GALLONS GALLONS <br />Tank Material: <br />A&4 <br />Tank Manufacturer: <br />C <br />Product Stored: <br />6c-4- S- 7 <br />i <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />15 Minutes <br />15 Minutes <br />15 Minutes 15 Minutes <br />Test Start Time: <br />^• y 5' <br />:;rte <br />ra <br />Initial Reading (RO: <br />/c" HG <br />i c " HG <br />f e<" HG "HG <br />Test End Time: <br />/C,. -,v ' <br />�P, yo <br />9"0C) <br />Final Reading (RF): <br />X" HG <br />/ c " HG <br />e 4) " HG -HG <br />Test Duration: <br />1 Hour <br />1 Hour <br />1 Hour 1 Hour <br />Change in Reading (RF -RI): <br />" HG <br />O " HG <br />015 " HG "HG <br />Pass/Fail Threshold or Criteria: Zero Zero Zero Zero <br />Naggig . <br />Was sensor removed for testing? ❑ Yes J0 No ❑ NA ❑ Yes E&No ❑ NA ❑ Yes CR No ❑ NA ❑ Yes ❑ No ❑ NA <br />Was sensor properly replaced and <br />verified functional after testing? <br />0 Yes ❑ No ❑ NA <br />ER Yes ❑ No ❑ NA <br />® Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA <br />COmmentS — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />Chevron # 201383 <br />1960 W. 11 Street <br />Tracy, CA 95387 <br />N05203 -SB 989 Tessin <br />' Secondary containment systems where the w,iti„uvu� ..,.,,,.t.,_.,.� u��.,===u=., u.===. _.=..,.s 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)) <br />