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SWRCB, January 2002 <br />v <br />Page 2— of <br />4. TANK ANNULAR TESTING <br />Test Method Developed By: V/Tank Manufacturer ❑ industry Standard ❑ Professional Engineer <br />ther (Specify) <br />Test Method Used: ❑ Pressure vacuum ❑ Hydrostatic <br />❑ Other (SDecifv) <br />Test EauinmentUsed: A - An... ...v. bNL.......__ r --.,An<:,, U I EauinmentResolution:_t 11 ---z.,,-L—. <br />Tank # <br />Is Tank Exempt From Testing?' ❑ Yes o <br />Tank # .. Tank # <br />❑ Yes KNo ❑ Yes ❑ No <br />`Wank # <br />❑ Yes ❑ No <br />Tank Capacity: 0 i 0 3 6q1( <br />1 Vil Gall tN, S <br />Tank Material: is ✓ c{{ g`r <br />tt � Gv e, 5s <br />Tank Manufacturer: Xe�{2j« <br />E Y X E S <br />1 <br />Product Stored: Z e_ t a <br />u <br />i' <br />Waittime be applying <br />pressure/ acuum/ ter and <br />startin t ✓ <br />0 14 <br />f <br />Test Start Time: ' <br />3 d <br />p" <br />Initial Reading (RI): <br />Test End Time: <br />Final Reading (RF): <br />Test Duration: Z 6 VIV, 5Z <br />o v S <br />Change in Reading (RF -RI): <br />0.. <br />'� <br />Pass/Fail Threshold or Criteria: Pfd Los t 14-4- <br />,V o L®5 s 14 4 <br />Test Result: X Pass ❑ Fail <br />ass ❑ Fail ❑ Pass ❑ Fal <br />Pass ❑ it <br />Was sensor removed for testing? ❑ Yes o ❑ NA <br />❑ Yes 6 ❑ NA es ❑ No ❑ <br />Yes ❑ No ❑ A <br />Was sensor properly replaced and ❑yes ❑ No TA <br />verified functional after testin ? <br />❑Yes ❑ No 1VA Yes ❑ No ❑ NA <br />Yes ❑ No ❑ <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <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 />testing. {California Code of Regulations, Title 23, Section 2637(a)(6)) <br />