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C <br />SWRCB, January 2002 <br />Test Method Developed By: <br />Test Method Used: <br />Test Equipment Used: Oro*,s <br />Page )— of <br />Is Tank Exempt From Testing?' ❑ Yes o <br />❑ Yes No ❑ Yes ❑ No <br />❑ Yes ❑ No <br />Tank Capacity: <br />Tank Material: [ o S <br />6-1 &S . <br />, B <br />Tank Manufacturer: M()A r Vt <br />r' -(e) <br />.Product Stored: u eco r <br />p d ese SLt to <br />Wait time between applying <br />startingpressurWVk—tes : uum/w er and o ✓ <br />Test Start Time: ;'j L) <br />d j <br />Initial Reading W:( <br />— h <br />Test End Time: U ".00 <br />�D; O <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (RF --N: P-5 _ <br />#c <br />Pass/Fail Threshold or Criteria: ND 0055 M Rq <br />tit) (v SS rn V+ ' <br />Test Result: x1pass ❑ iall <br />ass ❑ Fail Pass ❑ all <br />❑ Pass ❑ Fail ' <br />Was sensor removed for testing? es ❑ No ❑ NA <br />es ❑ No ❑ NA ❑ es ❑ No NA <br />❑ Yes ❑ No ❑ NA <br />Was sensor properly replaced and es ❑ No ❑ NA <br />verified functional after testin ? <br />es ❑ No ❑ NA JYes ❑ No ❑ A <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(x)(6)1 <br />