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Recommended Practices for the Testing and Verification of Spill, Overfill, Leak Detection and Secondary Containment Equipment at UST Facilities <br /> 777777777 <br /> l • ftii <br /> PFaty Name: ENE Owner: <br /> Address: Address: <br /> Cityt State, Zip Code: City, . State, Zip Code: <br /> Facility I.D. #, Phone #: <br /> Testing Company: Phone #s Date: <br /> This procedure is to test the leak integrity of containment sumps. See PEI%RP1200 Section 6.5 for the test method. <br /> Containment Sump ID <br /> Containment Sump <br /> Material <br /> Liquid and debris <br /> removed from sump?* ❑ Yes ElNo 11 Yes 11No ❑ Yes ❑ No ❑ Yes ElNo ElYes 11No ❑ Yes ❑ No <br /> Visual Inspection (No <br /> cracks, loose parts ❑ pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fall ❑ Pass [] Fall ❑ Pass ❑ Fall ❑ Pass ❑ Fail <br /> or separation of the <br /> containment sump.) <br /> Containment Sump <br /> Depth <br /> Height From Bottom to <br /> Top of Highest <br /> Penetration <br /> Starting Water Level <br /> Test Start Time <br /> Ending Water Level <br /> Test End Time <br /> Test Period (Minimum <br /> test time: 1 hour) <br /> Water Level Change <br /> Pass/fail criteria: Must pass visual inspection. Water level drop of less than 1/8 inch. <br /> Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> Comments: <br /> *All liquids and debris must be disposed of properly. <br /> Tester's Name (print) Tester's Signature <br /> pei . org <br />