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= SWRGB, January2002 <br />S. OLL RISER CONT NTS ASTING <br />Facility is Not E ui ed With Fill Riser Containment Sumps <br />Fill Riser Containment Sumps are Present, but were Not Tested ❑ <br />T,t Method Developed By: ❑ Sump Manufacturer .❑ Industry Standard <br />❑ Other (Spec) <br />Test Method Used: ❑ Pressure ❑ Vacuum <br />❑ Other (Spec) <br />Test Eauinment sed: I <br />Sump Diameter: <br />Sump Depth: <br />Height from Tank Top to Top of <br />Highest Pi in Penetration: <br />Height from Tank Top to Lowest <br />Electrical Penetration: <br />Condition of sump prior to <br />testin <br />Portion of S!!Lnp Tested <br />Page (a of % <br />❑ Professional Engineer <br />❑ Hydrostatic <br />i Sum # Fill Sump# Fill Sump # Fill Sumn # <br />Oump Material. <br />Wait time between applying <br />pressure/vacuum/water and <br />startin test: <br />Test Start Time: <br />Initial Reading190: <br />Test End Time: <br />Final Reading : <br />Test Duration: <br />Chane in Reading (RF -RI): <br />Pass/Fail Threshold or Criteri <br />Test Result: <br />0 Pass 11Fail <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />❑Pass ❑Fail <br />Is there a sensor in the s p? <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes <br />❑ No <br />Yes <br />❑ No <br />Does the sensor al hen <br />either product or er is <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No <br />❑ NA <br />❑ Yes ❑ <br />❑ NA <br />detected? <br />Was sensor removed for testing? <br />❑ Yes ❑ No, D_NAT <br />❑ Yes ❑ No ❑ NA <br />❑ Yes O No <br />❑ NA <br />❑ Yes ❑ No <br />❑ NA <br />Was sensor`properly replaced and <br />verified functional after testins? <br />❑ yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No <br />❑ NA <br />❑ Yes ❑ No <br />❑ NA <br />Comments — (include information on repairs made prior to testing and recommended follow up for failed tests) <br />