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SWRCB, January 2002 <br />9 SPI&OVERFILL CONT NT BOXES <br />Facility is Not t;quipea w1ui aPuu'Ljvcii,,, <br />Spill/Overfill Containment Boxes are Present, but were Not Tested ❑ <br />Test Method Developed By: ❑ Spill Bucket Manufacturer <br />❑ Industry Standard ❑ Professional Engineer <br />❑ Other (Spec) <br />Test Method Used: <br />❑ Pressure <br />❑ Vacuum ❑ Hydrostatic <br />❑ Other (Specify) <br />Test Equipment Used: <br />Equipment Resolution: <br />441 <br />Spill Box # Spill Box # Spilf 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): <br />Test End Time: <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (RF -RI): <br />Pass/Fail Threshold or <br />Criteria: <br />•.,_ . ,',. <br />n Parc ❑ Fail ❑ Pass <br />❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />A C;a L laa..ucare <br />Commenits — (include in or nation on re airs made prior to testing, and recommended follow-up for failed tests) <br />Please direct any comments regarding this form to: <br />SWRCB UST Program, Atm: Scott Bacon <br />1001 "I" Street, Box 944212 <br />Sacramento, CA 95814 <br />Phone: (916) 341-5873, Fax: (916) 341-5808 <br />e-mail: bacons@cwp.swrcb.ca.gov <br />