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SWRCB, January 2002 <br />Page of— <br />FILL RISKR CONT TEST NG <br />'Facility is Not uipped With Fill <br />Riser Containment 3 <br />s <br />Fill Riser Containment S!Ms are Present, but were Not Tested <br />Teat Method Developed By: <br />Sump Manufacturer <br />d <br />Professions] Engineer <br />Other (Np*C#Y, ) <br />Test Method Used: <br />pressure <br />Vacuum <br />i stn — <br />Other (Spec) <br />Test Equipment Us <br />Equipment Resohition: <br />' <br />Fin Sum !1"7 c,. <br />Fin Sump #6f t <br />Fill sum <br />Fill s! # <br />Surnp, Di6mater. <br />Lis « <br />L41 YY <br />Alm u <br />iy <br />? f <br />Height from Tank Top to Top of <br />ffiLh—est i Penetration: <br />o A <br />N A <br />N� <br />Height from Tank Top to Lowest <br />'on: <br />�r+ <br />Eiectricsl l? <br />Condition of sump prior to <br />' <br />res <br />Portion of'S Tested <br />r..cs <br />rR,ies <br />sump M <br />,mss <br />Wait time between applying <br />presaure/vacuum/water and <br />f U %+'1.6% <br />(,[! JM I in <br />W <br />atKtwg teat: <br />Test Start Time: <br />Initial Reagin <br />(. <br />Test End Time: <br />t <br />Final Reed" <br />e. <br />Teat Duration: <br />`��' t <br />if—j-% <br />Chan in R <br />Pass/Fall Threshold or Criteria: <br /># <br />vv -C— <br />. a <br />Z <br />TestResult: <br />D aU <br />❑ Fail <br />® o Fall <br />o Fait <br />Is there a sensor is the ? <br />No <br />No <br />Yes <br />No <br />No <br />Does the scnaor alarm when <br />eithcr pm&or water is <br />Y No NA <br />No NA <br />Yen No <br />NA <br />No NA <br />do�cted? <br />Was sensor removed for =;;�;:] <br />No NA <br />No NA <br />Yes No <br />NA <br />No NA <br />Was sensor lY repl <br />verified functional after' t <br />--.:.� No NA <br />Y No NA <br />Yes No <br />NA <br />No NA <br />