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SWRCB, January 2002 Page of <br /> S. FILL RISER CONTAINMENT SUMP TESTING <br /> Facility is Not Equipped With Fill Riser Containment Sumps ❑ <br /> Fill Riser Containment Sumps are Present,but were Not Tested ❑ <br /> Test Method Developed By: ❑Sump Mamufactuurer ❑Industry Standard ❑Professional Engineer <br /> ❑Other(Sped) <br /> Test Method Used: ❑Pressure ❑Vacuum ❑Hydrostatic <br /> ❑Other(Specify) <br /> Test Equipment Used: Equipment Resolution: <br /> Fill Sump# Fin Sump# Fill SUMP# Fill SUMP# <br /> Sunup Diameter: <br /> Sump Depth: <br /> Height from Tank-Top to Top of <br /> Hi est Piping Penetration: <br /> Height from Tank Top to Lowest <br /> Electrical Penetration: <br /> Condition of sulnp prior to <br /> testing: <br /> Portion of Sump Tested <br /> Sump Material: <br /> Wait time between,applying <br /> pressure/vacuuuln/water and <br /> starting test: <br /> Test Start Time: r <br /> Initial Reading(RO: <br /> Test End Time: <br /> Final Reading(RF): `3 <br /> Test Duration: <br /> Change in Reading(RF-R;): <br /> Pass/Fad Threshold or Criteria: <br /> Test Result: ❑ Pass ❑]Fail ❑ Pass ❑Fail ❑ Pass ❑Fail ❑ Pass ❑Fail <br /> Is there a sensor in the sump? 5 Yes ❑No ❑Yes ❑No ❑Yes ❑No ❑Yes ❑No <br /> Does the sensor alarm when <br /> either product or water is ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA <br /> detected? <br /> Was sensor removed for testing? ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA <br /> Was sensor properly replaced and ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA <br /> verified functional after testing? <br /> Comments-(include information on repairs made prior 04'sibig,' a; recommended follow-up for failed tests) <br />