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Test Method Developed By: <br />Test Method Used: <br />Test Equipment Used: vac V <br />11 <br />industry Standar,7, <br />#1 <br />Professional Engineer <br />Hydrostatic <br />Resolution: -1.0 <br />7 <br />C® ell — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />Note PremiumlDiesel and Unleaded tanks are double wall tank wet annulars hydrostatic system. <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. <br />Tank #Unleaded <br />Tank #Premium <br />Tank #Diesel <br />Tank # <br />Is Tank Exempt From Testing?' <br />Yes Ej No <br />Z Yes ❑ No <br />Yes E] No <br />❑ Yes El No <br />Tank Capacity: <br />Tank Material: <br />Tank Manufacturer: <br />Product Stored: <br />gasoline <br />gasoline <br />diesel <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 />Pass/Fail Threshold or Criteria: <br />Test Result: <br />Ej pass Fail I <br />Pass Fall <br />Ej pass []Fail <br />Pass []Fail <br />Was sensor removed for testing? <br />nYes El No [] NA <br />[:1 Yes [:1 No 0 NA <br />OYes E—] NO EINA <br />E] Yes [] No El NA <br />Was sensor properly replaced and <br />verified functional after testing? <br />[3 Yes E] Non NA <br />❑ Yes E:1 No El NA <br />El YesO NO 0 NA <br />El Yes El NO 1:1 NA <br />C® ell — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />Note PremiumlDiesel and Unleaded tanks are double wall tank wet annulars hydrostatic system. <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. <br />