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SWRCB, January 2002 <br />4. TANK ANNULAR TESTING <br />Page of <br />Test Method Developed By: <br />❑ Tank Manufacturer O`)ndustry Standard ❑ Professional Engineer <br />❑ other (Specify) <br />Test Method Used: <br />❑ Pressure <br />❑ Other (Specify) <br />KVacuum <br />❑ Hydrostatic <br />Test Equipment Used: <br />Equipment Resolution: <br />Is Tank Exempt From Testing?' <br />Tank # <br />❑ Yes tlNo <br />Tank # <br />Tank # <br />Tank # <br />❑ Yes RNo <br />❑ Yes ❑ No <br />❑ Yes 11 No <br />Tank Capacity: <br />' ^• ' <br />i, <br />Tank Material: <br />E <br />.. <br />Tank <br />�M}a[n{.ufa�cjturer: <br />Product Stored: <br />2 b <br />Wait time between applying <br />pressure/A acuum/Avater and <br />starting test: <br />'` <br />' <br />! •: <br />Start Time: <br />Initial <br />Initi,1Reading (1:4): <br />.•• ! <br />,� 4 <br />Test End Time: <br />IV <br />Final Reading (RF): <br />Test Duration: <br />, <br />��pp gpg'-., <br />Change m g (RF-R>�: <br />Pass/Fail Threshold or Criteria: <br />Test Result: <br />lPass ❑ Fail <br />Pass ❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fait <br />Was sensor removed for testing? <br />0 Yes ❑ No ❑ NA <br />es ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />Was sensor properly replaced and <br />verified fimctional after testis ? <br />®'yes ❑ No ❑ NAes <br />❑No ❑NA <br />❑ Yes ❑ No 0N <br />❑Yes 0N 0N <br />Comments — (include informalion on repairs made prior to testing, and recommended follow-up for failed tests) <br />f" <br />L� <br />1cz� <br />--X— <br />V <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 />tactina Wnlifnrnia (`nriP of P? (Ysilatinne Titir 11 Qartinn 16TWaVAIA <br />