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Recommended Practices for the Testing and Verification of Spill,Overfill,Leak Detection and Secondary Containment Equipment at UST Facilities <br /> APPENDIX C-4 <br /> CONTAINMENT SUMP INTEGRITY TESTING <br /> HYDROSTATIC OD <br /> Facility Name: Owner: <br /> Address: Address: <br /> City,State,Zip Code: City,State,Zip Code: <br /> Facility I.D.#: Phone#: <br /> Testing Company. Phone#: 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 []Yes ❑No []Yes ❑No []Yes ❑No ❑Yes ❑No ❑Yes ❑No ❑Yes ❑No <br /> removed from sump?* <br /> Visual Inspection(No <br /> cracks,loose parts ❑Pass ❑Fail ❑Pass ❑Fail ❑Pass ❑Fail ❑Pass ❑Fail ❑Pass ❑Fail ❑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 />