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MAD it (347-6-03 <br />9430 We Pom bo P kwy <br />4. TANK ANNULAR TESTING Tr CX <br />Test Method Developed By. -%Tank Manufacturer .95 Industry Standard ❑ Professional Engineer <br />0 Other (Spec) <br />Test Method Used: ❑ Pressure R Vacuum 0 Hydrostatic <br />❑ Other (Specie) <br />Test Equipment Used: .. ,rj Z rG k &Gt �6 Equipment Resolution: 0,5 j yt ,'-tG <br />Is Tank Exempt From Testing? <br />Tank #$? JLj Y <br />❑ Yes 51 No <br />Tank # cj(-915Ee`ve. <br />❑ Yes U No <br />Tank # <br />❑ Yes 0 No <br />Tank # <br />❑ Yes ❑ No <br />Tank Capacity: <br />Z® 000 GG` { <br />(2 000 i0 Dao <br />Tank Material: <br />Tank Manufacturer. <br />it meY <br />Product Stored: <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />U, ! <br />MC. <br />l I r . <br />Test Start Time: <br />, ; • <br />'�: C <br />Initial Reading (Rt): <br />W-6 in M <br />-� <br />Test End Time: <br />( P <br />®tJ P <br />Final Reading (RF): <br />1 <br />Test Duration: <br />` <br />Change in Reading (RF-Rj): <br />0. ` <br />• Vl <br />Pass/Fail Threshold or Criteria: <br />r � h <br />;;Test:>ReSult_ __....._.-._'piiss_- <br />CT1Farl,°_.; : <br />;. - Pass :. ❑;Earl'' ''` <br />--' <br />............. <br />:: Di'<::: -_ <br />•-= `�Fail.�ass:..: <br />. <br />Fail <br />Was sensor removed for testing? <br />n4 • <br />XYes ❑ No ❑ NA <br />es ❑ No 0 NA <br />Q Yes Q No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />Was sensor properly replaced and <br />verified functional after testing? <br />.Yes ❑ No ❑ NA <br />XYes 0 No ❑ NA <br />❑ Yes Q No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />Comments — (include information on repairs made prior to testing and recommended follow-up for failed tests) <br />t 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)1 <br />Paee 2 of 7 1/13/2003 !?® <br />e <br />