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Amp it (031-? Z -G-03 <br />1 -30 a Porn 6o Pkwy <br />4. TANK ANNULAR TESTING Yr CA z <br />Test Method Developed By: "Tank Manufacturer 0Industry Standard ❑ Professional Engineer <br />❑ Other (Spec) <br />Test Method Used: ❑ Pressure R Vacuum ❑ Hydrostatic <br />O Other (Spec) <br />Test Equipment Used: ,�j I C (,� G Gt LkEj Equipment Resolution: a, S ' r ,14 ,• <br />Tank #,9?) &Ster Tank # �� $'tSiceV�. Tank # <br />Is Tank Exempt From Testing?' O Yes lid No ❑ Yes U No ❑ Yes ❑ No <br />Tank # <br />❑ Yes ❑ No <br />Tank Capacity: ).0 Q©d GGa { <br />)% j(, 0W(} GA <br />Tank Material: Fiber-coass <br />F i b e1!' iot cs <br />Tank Manufacturer: r- <br />r <br />Product Stored: $ <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: M " <br />Test Start Time: <br />Initial Reading (Rt): Q n M <br />�, <br />Test End Time: i P <br />S PM <br />Final Reading (RF): , <br />- <br />Test Duration: <br />Change in Reading (RF -RI): (7 ' N <br />• V% <br />Pass/Fail Threshold or Criteria: 1 J <br />2r0 1 YX N <br />77777777777777- - - <br />a <br />Pass ❑,F�1 "..' <br />- - - <br />C]:Pas.'•DFail <br />L7 Pr ig ; ;IJ.,Fail <br />Was sensor removed for testing? XYes ❑ No O NA <br />Was sensor properly replaced and <br />verified functional after testing? .Yes ❑ No ❑ NA <br />Yes ❑ No ❑ NA <br />XYes ❑ No ❑ NA <br />❑ Yes O No ❑ NA <br />Yes ❑ No ❑ NA <br />E <br />❑ Yes ❑ No ❑ NA <br />❑ Yes O No ❑ NA <br />Comments — (include information on repairs made prior to testing, and recommended follow -u for ailed tests) <br />1 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(a)(6)) <br />Paee 2 of 7 1/13/2003 A�� <br />