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SWRCB, January 2002 <br />cq <br />Page Z"of <br />Test Method Developed By: ❑ Tanlc Manufacturer .Cjndustry Standard ❑ Professional Engineer <br />❑ Other (Spec) <br />Test Method Used: ❑ Pressure krVacuum ❑ Hydrostatic <br />❑ Other (Sped) <br />Test Equipment Used: <br />Tank # 7 Tank # 4;-ce <br />Is Tank Exempt From Testing?' ❑ Yes ❑ No ❑ Yes ❑ No <br />Equipment Resolution <br />Tank # Tank # <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Tank Capacity: <br />Tank Material: <br />Tank Manufacturer: <br />Product Stored: <br />i 5' <br />% <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />Test Start Time: <br />15 "'1 <br />3 a <br />= <br />Initial Reading (R): <br />i d " 1-1 V" ' C <br />i e ` ` 116 <br />Test End Time: <br />D ! 3 3 <br />Final Reading (RF): <br />1 u ' C 10 <br />Test Duration: <br />) C AIIA <br />1 v <br />Change in Reading (RF -RD: <br />Pass/Fail Threshold or Criteria: <br />Test Result: <br />9 Pass ❑ Fail Pass ❑ Fail <br />9 Pass ❑ Fail <br />❑ Pass ❑ Fail <br />Was sensor removed for testing? <br />❑ Yes 1$No ❑ NA ❑ Yes -ONO ❑ NA <br />❑ Yes KNo ❑ NA <br />❑ Yes ❑ No ❑ NA <br />Was sensor properly replaced and <br />verified functional after testin ? <br />❑ yes ❑ No 4 NA ❑ Yes ❑ No M NA <br />❑ Yes ❑ No 2.NA <br />❑ Yes ❑ No ❑ NA <br />Comments — (inchide information on repairs made prior to testing, and recommended follow-up for failed tests) <br />' Secondary containment systems whet <br />containment, such as systems that are 1 <br />testing. {California Code of Regulation <br />Chevron #20-1383 <br />1960 W. 11`s St. <br />Tracy, Ca 95376 <br />SB 989 Nick Harvey <br />#N11093 <br />itors both the primary and secondary <br />ium, are exempt from periodic containment <br />