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SWRCB, January 2002 <br />4. TANK ANNULAR TESTING <br />Page 2 of G <br />Test Method Developed By: 0 Tank Manufacturer Industry Standard ❑ Professional Engineer <br />❑ Other (Specify) <br />Test Method Used: ❑ Pressure Vacuum ❑ Hydrostatic <br />❑ Other (Specify) <br />Test Equipment Used: t► V c" - � Equipment Resolution: e) <br />�,. y `• �, e,. �r :�`, s�""�. t�.,x s.v.77.��'a <br />Tank # 4,i f <br />.z.H. 7'77 <br />Tank # ra gs/ Tank # <br />Tank # <br />Is Tank Exempt From Testing?' <br />❑ Yes es' Jo <br />❑ Yes aNQ ❑ Yes ❑ No <br />❑ Yes ❑ No <br />Tank Capacity: <br />Tank Material: <br />Tank Manufacturer: <br />Product Stored: <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />();-A r" -'I <br />l0 <br />Test Start Time: <br />Initial Reading (RI): <br />Test End Time:; <br />u <br />Final Reading (RF): <br />sl <br />•-'' <br />Test Duration: <br />Change in Reading (RF -R,): <br />Pass/Fail Threshold or Criteria: <br />13�.- <br />Test Result: <br />A:� Pass ❑ Fail <br />,9 Pass ❑ Fail ❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />Was sensor removed for testing? <br />04Yes ❑ No ❑ NA <br />QYes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />Was sensor properly replaced and <br />verified functional after testing? <br />1. -Yes ❑ No ❑ NA <br />6Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary <br />containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment <br />testing. {California Code of Regulations, Title 23, Section 2637(a)(6)) <br />