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% 0 Pa L of <br />— <br />Test Method Developed By: <br />T <br />Test Method <br />d Used: <br />Test Eauioment Used: vac 9 <br />Is Tank Exempt From Testing?' <br />Tank Capacity: <br />Tank Material: <br />Tank Manufacturer: <br />Product Stored: <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: .. <br />Test Start Time: <br />Initial Reading (Rj): <br />Test End Time: <br />Final Reading (RF): <br />Test Duration: <br />[Change in Reading (RF -R,): <br />D—/Pn;1 ThrPehnIA nr Critp.rin- <br />!Ve�F' I <br />D Tank Mani <br />❑ Other (Spe <br />❑ Pressure <br />E] Other (Spe <br />P <br />watch <br />I FM 391=- - <br />gasoline <br />O <br />turer Z industry Standard f-1 Professional Eno, wer <br />Mvacuum E] Hydrostatic <br />Equipment Resolution: -I. <br />Tank #Premium Tank #Diesel Tank <br />M No M Yes [-] No El � -,s ❑ No <br />gasoline I diesel <br />Q�� <br />Test Result: <br />D Pass D F 4jl <br />D Pm [:]Fail <br />El Pass D Fail <br />n ss El Fail <br />Was sensor removed for testing? <br />E]Yes El No [IA <br />El Yes El No El NA <br />Dyes El NO DNA <br />D n Y El No DNA <br />- <br />Was sensor properly replaced and <br />verified functional after testing? <br />❑ Yes D NoF1 NA <br />El Yes D No n NA <br />D YesD No D NA <br />n No [-] NA <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />Note PremiunzIDiesel and Unleaded tanks are double wall tank wet annulars hydrostatic system., <br />PAGE -2 of 8 <br />Secondary containment systems where the continuous monitoring automatically monitors both the primary and <br />containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from peri <br />testing. <br />