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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 6. SPILL CONTAINER DETAILS <br /> Test Method Developed by ® Manufacturer ® Industry Standard ® Professional Engineer <br /> Test Type ® Pressure ® Vacuum ® Hydrostatic <br /> Tank ID 91 <br /> Spill Container Manufacturer: OPW <br /> Method of Cathodic Protection ® Nonmetallic ® Nonmetallic ® Nonmetallic ® Nonmetallic <br /> M Other ® Other ® Other ® Other <br /> Is the spill container minimum ® Yes ® Yes ® Yes ® Yes <br /> capacity five gallons excluding ® No* ® No* ® No* ® No* <br /> riser volume? <br /> Method to keep spill container ® Drain ® Drain M Drain ® Drain <br /> empty ® Pump ® Pump ® Pump ® Pump <br /> ® Other ® Other ® Other p Other <br /> Spill Container Test Results 11 Pass ® Pass r7l Pass ® Pass <br /> I L7 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 ® Yes ® Yes ® Yes ® Yes <br /> capacity five gallons excluding ® No* No* ® No* ® No* <br /> riser volume? <br /> Method to keep spill container ® Drain ® Drain M Drain ® Drain <br /> empty ® Pump ® Pump rj Pump ® Pump <br /> ® Other ® Other [fJ" Other ® Other <br /> Spill Container Test Results El Pass ® Pass ® Pass ® Pass <br /> ® Fail ® Fail ® Fail ® Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other," "No," or "Fail'and each proposed remedy. <br /> * Mark here if: <br /> ® S ill containers do not have a minimum capacity of five gallons and require replacement. <br /> Additional copies of this page may be attached. <br /> Page 2of2 <br />