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Underground Storage Tank Secondary Containment Testing Report Form 6. TANK SECONDARY CONTAINMENT TEST Test Method Developed by ® Manufacturer ® Industry Standard ❑ Professional Engineer Test Type ❑ Pressure ® Vacuum ❑ Hydrostatic Test Equipment Used: 20' Hg vacuum gauge Tank ID T1 87 Master T2 87 Syphon T3 91 Tank Manufacturer Uknown Uknown Uknown Tank Capacity 12,000 12,000 12,000 Test Start Time 6:OOam 6:15am 7:OOam Initial Reading -10' Hg -10' Hg -10' Hg Test End Time 7:OOam 7:15am 8:OOam Final Reading -10' Hg -10' Hg -10' Hg Change in Reading 0 change 0 change 0 change Pass/Fail Criteria 0 change/1 hr 0 change/1 hr 0 change/1 hr Tightness Test Results ® Pass ❑ Fail I ® Pass ❑ Fail I ® Pass ❑ Fail ❑ Pass ❑ Fail 7. PIPE SECONDARY CONTAINMENT TEST Test Method Developed by ® Manufacturer ® Industry Standard ❑ Professional Engineer Test Type ® Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used: 10 psi pressure gauge Pipe Run ID T1 87 master T2 87 syphon T3 91 Vapor pot Pipe Manufacturer Fiberglass Fiberglass Fiberglass Fiberglass Test Start Time 6:OOam 6:OOam 6:30am 6:30am Initial Reading 5 psi 5 psi 5 psi 5 psi Test End Time 7:OOam 7:OOam 7:30am 7:30am Final Reading 5 psi 5 psi 5 psi 5 psi Change in Reading 0 Change 0 Change 0 Change 0 Change Pass/Fail Criteria 0 change - 1 hr 0 change - 1 hr 0 change - 1 hr 0 change - 1 Tightness Test Results ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail Pipe Run ID Pipe Manufacturer Test Start Time Initial Reading Test End Time Final Reading Change in Reading Pass/Fail Criteria Tightness Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail Additional copies of this page may be attached. All tests marked "Fail"and any repairs made before or during the tightness test must be described in the COMMENTS section. Page 2 of 5