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wKuij, .ianuary z-uuL <br />am ► '111►/ <br />Facility is Not Equipped With Spfll/C erfill Containment Boxes ❑ <br />Spill/Overfill Containment Boxes are Present, but were Not Tested ❑ <br />Test Method Developed By: ❑ Spill Bucket Manufacturer 0,1ndustry Standard ❑ Professional Engineer <br />❑ Other (Specify) <br />Test Method Used: ❑ Pressure ❑ Vacuum fi(Iydrostatic <br />❑ Other (Spec) <br />Test Equipment Used: ' r Equipment Resolution: <br />Catsst�tt�ti6%rt.MEN7@Fa�a�a�%*o��s7�°�<:rt��7�;�m��s�"a;, <br />}" Spill Box # Spill Box # Spill Box # Spill Box # <br />Bucket Diameter: <br />Bucket Depth: <br />Wait time between applying / <br />pressure/vacuum/water and <br />starting test: <br />Test Start Time: <br />Initial Reading (Rj): A' <br />Test End Time: j 0 /.,fir <br />Final Reading (RF): <br />Test Duration:,% 4 <br />Change in Reading (RF-Rj): L:: <br />Pass/Fail Threshold or <br />Criteria: <br />Test Result: a` Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />Commends — (include information on re aifs made prior to testing, and recommendedJollow-up jor jauea tests) <br />f7lo i jo Ry C k r . <br />