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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 1. SPILL CONTAINER DETAILS <br /> Test Methods Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer <br /> Tank ID 87 91 DSL <br /> Spill Container Manufacturer OPW OPW OPW <br /> Method of Cathodic Protection ® Nonmetallic ® Nonmetallic ® Nonmetallic PE] Yes <br /> ❑ Other El Other E] Other <br /> Is the spill container minimum <br /> capacity five gallons excluding ® Yes ® Yes ® Yes riser volume? ❑ No* ❑ No* ❑ No*Method to keep spill container ® Drain ® Drain ® Drain empty ❑ Pump ❑ Pump ❑ Pump❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ® Pass ® Pass ® Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer <br /> Method of Cathodic Protection ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum El Yes capacity five gallons excluding ❑ Yes ❑ Yes ❑ Yes <br /> riser volume? ❑ No* ❑ No* ❑ No* ❑ No* <br /> Method to keep spill container ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail E] Fail ❑ Fail E] Fail <br /> 2. COMMENTS <br /> Describe all answers marked "Other'; `No, or 'Fail"and each proposed remedy. <br /> *Mark here if <br /> ❑ Spill containers do not have minimum capacity of five gallons and require replacement. <br /> Page 8 of 8 <br />