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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 <br />87 <br />91 <br />Spill Container Manufacturer: <br />OPW <br />OPW <br />® Nonmetallic <br />® Nonmetallic <br />❑ Nonmetallic <br />❑ Nonmetallic <br />Method of Cathodic Protection <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />Is the spill container minimum <br />® Yes <br />® Yes <br />❑ Yes <br />❑ Yes <br />capacity five gallons excluding <br />riser volume? <br />❑ No* <br />❑ No* <br />❑ No* <br />❑ No* <br />® Drain <br />® Drain <br />❑ Drain <br />❑ Drain <br />Method to keep spill container <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />empty <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />® Pass <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />Spill Container Test Results <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />Tank ID <br />Spill Container Manufacturer: <br />❑ Nonmetallic <br />❑ Nonmetallic <br />❑ Nonmetallic <br />❑ Nonmetallic <br />Method of Cathodic Protection <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />Is the spill container minimum <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />capacity five gallons excluding <br />riser volume? <br />❑ No* <br />❑ No* <br />❑ No* <br />❑ No* <br />❑ Drain <br />❑ Drain <br />❑ Drain <br />❑ Drain <br />Method to keep spill container <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />empty <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />Spill Container Test Results <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />8. COMMENTS <br />Describe all answers marked "Other," "No,"or "Fail" and each proposed remedy. <br />* Mark here if: <br />❑ Spill containers do not have a minimum capacity of five gallons and require replacement. <br />Additional copies of this page may be attached. <br />Page 2 of 2 <br />