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a It F;a 1 CIF <br />:7 <br />W.".,i.-_Y -4 AIA I UM Id W14 YL;0. f► <br />Page of <br />Facility is Not Equipped With FM Ryser C am Sum ps <br />FillRiser Contammebt Sumps are Present, but were Not Tested 0 <br />Test Method Developed By: <br />0 Sump Mamficturer <br />0 Other (Specify) <br />0 Industry Standard 0 Professional Finginew <br />Test Method Used: <br />0 Pressure <br />0 Other (Specify) <br />0 vacuum <br />0 Hydrostatic <br />Test Used:quonent <br />Sump DUmeter. <br />FiIE SumP # <br />Fa7i Som # <br />Res halon: <br />m Sump # FIU Sumv # <br />Suinp Depth.: <br />Height from Tank Top to Top of <br />Highest Piping Penetration: <br />from Tank Top to Lowest <br />Electrical Penetration: <br />Condition of sump prior to <br />Portion of jumR Tested <br />sump Material: <br />Wait time between applying <br />pr m/water and <br />starting test: <br />Test Start Time: <br />Initial Reading OQ: <br />Test End Time: <br />Final Reading N1 <br />Test 'on: <br />gLWE in <br />Pas&Tgd Threshold or Criteria: <br />Is there a sensor in the sump? <br />0 Yes 0 No <br />11 Yes 0 No <br />0 Yes 0 No 0 Yes 0 No <br />Does the sensor alarm when, <br />either product or water is <br />detected? <br />0 Yes 0 No 0 NA <br />I <br />OYes DNo ONA <br />0 Yes 0 N DNA oyes DNo ONA <br />Was sensor removed for 1est3nS? <br />O Yes 0 No 0 NA <br />0 Yes 0 No 0 NA <br />D Yes D No tDNA 0 Yes ONO DNA <br />Was sensor properly replaced and <br />verified fimctional atter <br />0 Yes 0 No 0 NA <br />0 Yes 0 No 0 NA <br />D Yes D No ONA 0 Yes 0 N 0 N <br />t ff It t k: !� ;t tl.I I 't+! et l.::t t lr ;.♦ 'rI ,.o ,r'! t /. y. t:: !�. ,t <br />0 <br />