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SWRCB, January 2002 Page of <br />8. FILL RISER CONTAINMENT SUMP TESTING <br />Facility is Not Equipped With Fill Riser Containment Sumps X <br />Fill Riser Containment Sumps are Present, but were Not Tested ❑ <br />Poly Plastic <br />❑ Sump Manufacturer ❑ Industry Standard ❑ Professional Engineer <br />❑ Other (Spec) <br />Test Method Used: <br />❑ Pressure ❑ Vacuum <br />❑ Other (Spec) <br />❑ Hydrostatic <br />Test Equipment Used: <br />Fill Sump # Fill Sump # <br />Equipment Resolution: <br />Fill Sump # Fill Sump # <br />Sump Diameter: <br />Sump Depth: <br />Height from Tank Top to Top of <br />Highest Pi ing Penetration: <br />Height from Tank Top to Lowest <br />Electrical Penetration: <br />Condition of sump prior to <br />testing: <br />Portion of Sump Tested <br />Sump Material: <br />Wait time between applying <br />water and starting test: <br />Test Start Time: <br />Initial Reading (RI): <br />Test End Time: <br />Final Reading (RF): <br />Test Duration: <br />Chan a in Reading RF-Ri : <br />Pass/Fail Threshold or Criteria: <br />Test Result: <br />o Pass ❑ Fail 0 Pass o Fail <br />❑ Pass 0 Fail ❑ Pass o Fail <br />Is there a sensor in the sump? <br />❑ Yes ❑ No ❑ Yes ❑ No <br />❑ Yes ❑ No ❑ Yes ❑ No <br />Does the sensor alarm when <br />either product or water is <br />detected? <br />❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA <br />Was sensor removed for testing? <br />Yes []No ❑ NA <br />❑ Yes ❑ No ❑ NAfD <br />❑ Yes ❑ No El NA ❑ Yes El No ❑ NA <br />Was sensor properly replaced and <br />verified functional after testin? <br />❑yes 11 No 11 NAYes 11No ❑ NA <br />Ll Yes ❑ No ❑ NA ❑Yes ❑ No [INA <br />Comments —(include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />