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08/27/2012 15:50 <br />(209) 465-4988 <br />0 <br />Henderson Maintenance Cc <br />11 <br />Page 318 <br />SWRCB, January 2002 <br />4. TANK ANNULAR TESTING <br />Page 2 <br />of 7 <br />Test Method Developed By: <br />0 Tank Manufacturer 0 Industry Standard 13 Professional Engineer <br />12 Other (Specify) <br />Test Method Used: <br />0 Pressure 0 Vacuum <br />0 Other (Specify) <br />0 Hydrostatic <br />[-Test Equipment Used: <br />Is Tank Exempt From Testing?' <br />Tank# Tank# <br />0 Yes 13 No 12 Yes 0 No <br />Equipment Rmfution: <br />Tank# Tank# <br />0 Yes ONo 0 Yes <br />0 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 />Test Start Time: <br />Initial Reading (RI); <br />Test End Time: <br />Final Reading(RF): <br />Test Duration: <br />Change in Reading (RrRO: <br />Pass/Fail Threshold or Criteria: <br />Test Result- <br />D pass 0 )Faft 0 PM 0 Fail <br />0 Pass 0 Fag 11 P= DFall <br />Was sensor removed for testing? <br />OYes ONo [INA OYes ONo DNA- <br />DYes ONo DNA DYes ElNo <br />DNA <br />Was sensor property replaced and 0 Yes 0 No 0 NA rl Yes rl'No 0 NA ClYes DNo DNA DYes DNo <br />,verified functional ager !Et9 - <br />Comments — (Include information on repairs made prior to testing, and recommended jb11ow-upLbrfvAtV s) <br />DNA <br />I <br />Annular Space is wet no testing needed <br />I 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(aX6)} <br />