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Underground Storage Tank <br />Secondary Containment Testing Report Form <br />6. TANK SECONDARY CONTAINMENT TEST <br />Test Method Developed by 17 Manufacturer 0 Industry Standard Professional Engineer <br />Test Type ® Pressure ® Vacuum ® Hydrostatic <br />Test Equipment Used: <br />Tank ID <br />Tank Manufacturer <br />Tank Capacity <br />Test Start Time <br />Initial Reading <br />Test End Time <br />Final Reading <br />Change in Reading <br />Pass/Fail Criteria <br />11 Tightness Test Results <br />10 Pass 17 Fail <br />® Pass ® Fail I <br />El Pass 0 Fail I r] Pass r] Fail <br />7. PIPE SECONDARY CONTAINMENT <br />TEST <br />Test Method Developed by El Manufacturer ® Industry Standard [I Professional Engineer <br />Test Type El Pressure rl Vacuum ® Hydrostatic <br />Test Equipment Used: Pressure Gauge <br />Pipe Run ID <br />87 <br />Pipe Manufacturer <br />Test Start Time <br />o min <br />Initial Reading <br />5 psi <br />Test End Time <br />50 min <br />Final Reading <br />5 psi <br />Change in Reading <br />o <br />Pass/Fail Criteria <br />Pass <br />Tightness Test Results <br />® Pass Fail <br />® Pass ® Fail <br />® Pass r] Fail <br />® Pass ® Fail <br />Pipe Run ID <br />Pipe Manufacturer <br />Test Start Time <br />Initial Reading <br />Test End Time <br />Final Reading <br />Change in Reading <br />Pass/Fail Criteria <br />Tightness Test Results <br />Pass ® Fail <br />I rl Pass ® Fail <br />® Pass El fail <br />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 />