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SWR.CB, January 2002 Page 6 of <br />R_ FILL RI-QG'I? vnw rA numrwrr vv Tam D rr, v v-v&T*- <br />Comments — (include Infor»urtion on repairs made prier ro terrir and recommended �oz'low-up ior�uiled rests) <br />- s�,v <br />Facili is Not ' ed With Fill Riser Containment Sum s <br />Fill Rim Containment LiEw are Present, but were Not T ed <br />est Method Developed By: U Sump Manufacturer U Industry Standard U Professional Engineer <br />U Other (Spew) <br />Test M Used: U Pressure U Vacuum U Hydrostatic <br />U Esher (Specify) <br />Testen# Resolutio <br />ed: Equip�m,..- <br />Fill Sum # Fill Sum # Fill Sum Fill Sum # <br />Dianyle, <br />egrom Tank Top to Top of \ <br />Mghest Piping Penetration: <br />Lieight from Tank Top to Lowest <br />Electrical Penetretidn: <br />Condition of sump prior to <br />testing: <br />ortionof Sum Tested <br />ait timebetween, applyingessyse/vacuum/water <br />rN <br />and <br />artin test <br />Test Start Time: <br />Initial. Readin J : <br />Test End Time: <br />Proal Reading &2: <br />Test Duration: <br />t:haa M, R _l2 <br />Pass/Fail Threshold -OT <br />MW <br />there a ? U Yes U No <br />U Yes UTI© U Yes NQ Na I <br />U Yes U No <br />Does the sensor oTm when <br />either product water is U Yes U No U NA <br />U Yes U No U NA U Yes U No U <br />U Yes U No U NA <br />detected? <br />Was seas removed for testing? U Yes U No U NA <br />U Yes U No U NA '-UYes U No U NA <br />U No U NA <br />Was ensor properly replaced and U Yes U No U NA <br />verified fimetional aiier ter ' T <br />U Yes U Nd U NA U Yes U No U NA <br />U Yes U U NA <br />Comments — (include Infor»urtion on repairs made prier ro terrir and recommended �oz'low-up ior�uiled rests) <br />