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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 ® Vacuum ❑ Hydrostatic <br /> Test Equipment Used: Vacuum Pump/Vacuum Gauge in Hg. <br /> Tank ID 91,91,Dsl Regular 87 <br /> Tank Manufacturer Trusco Trusco <br /> Tank Capacity 12K 3 Compt. 12K <br /> Test Start Time 9:25 9:30 <br /> Initial Reading -10" Hg. -10" Hg. <br /> Test End Time 10:25 10:30 <br /> Final Reading -10" Hg. -10" Hg. <br /> Change in Reading 0 0 <br /> Pass/Fail Criteria No Loss No Loss <br /> Tightness Test Results ® Pass ❑ Fail I ® 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: Pressure Gauges in Psi/Nitrogen <br /> Pipe Run ID 1-91 2-91 3-87 4-Diesel <br /> Pipe Manufacturer Ameron Ameron Ameron Ameron <br /> Test Start Time 9:35 9:40 9:45 9:50 <br /> Initial Reading 3 Psi 3 Psi 3 Psi 3 Psi <br /> Test End Time 10:35 10:40 10:45 10:50 <br /> Final Reading 3 Psi 3 Psi 3 Psi 3 Psi <br /> Change in Reading 0 0 0 0 <br /> Pass/Fail Criteria No Loss No Loss No Loss No Loss <br /> Tightness Test Results ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail ® 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 ❑ 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 />