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Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> 6. TANK SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure X Vacuum ❑ Hydrostatic <br /> Test Equipment Used: <br /> Tank ID 87 91 <br /> Tank Manufacturer Xerxes Xerxes <br /> Tank Capacity 20,000 15,000 <br /> Test Start Time 9:00 9:30 <br /> Initial Reading 10"hg 10"hg <br /> Test End Time 11:00 10:30 <br /> Final Reading 10"hg 10"hg <br /> Change in Reading 0 0 <br /> Pass/Fail Criteria 0 0 <br /> Tightness Test Results N Pass ❑ Fail ® Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer <br /> Test Type ® Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: <br /> Pipe Run ID 87 Product 91 Product 87 Tank Vent 91 Tank Vent <br /> Pipe Manufacturer Smith Smith Smith Smith <br /> Test Start Time 11:00 11:00 11:15 11:15 <br /> Initial Reading 5 5 5 5 <br /> Test End Time 12:00 12:00 12:15 12:15 <br /> Final Reading 5 5 5 5 <br /> Change in Reacting 0 0 0 0 <br /> Pass/Fail Criteria 0 0 0 0 <br /> Tightness Test Results ® Pass ❑ Fail ® Pass ❑ Fail ...1 X Pass ❑ Fail N Pass ❑ Fail <br /> Pipe Run ID Vapor <br /> Pipe Manufacturer Smith <br /> Test Start Time 11:15 <br /> Initial Reading 5 <br /> Test End Time 12:15 <br /> Final Reading 5 <br /> Change in Reading 0 <br /> Pass/Fail Criteria 0 <br /> Tightness Test Results M Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> Additional copies of this page may be attached. <br /> All tests marked "Fail"and any repairs made before or during the tightness test must be described in <br /> the COMMENTS section. <br /> Page 2 of 5 <br />