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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 <br /> Test Type ❑ Pressure ® Vacuum ❑ Hydrostatic <br /> Test Equipment Used : 0 to 30 inch hg , glycerin filled vacuum gauge(s) . <br /> Tank ID T1 Diesel <br /> Tank Manufacturer Xerxes <br /> Tank Capacity 550 <br /> Test Start Time 12:00 <br /> Initial Reading 10 <br /> Test End Time 13:00 <br /> Final Reading 10 <br /> Change in Reading 0 <br /> Pass/Fail Criteria 0 <br /> Tightness Test Results ® Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional <br /> Test Type ® Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used : 0 to 15 psi glycerin filled pressure gauge(s) . <br /> Pipe Run ID Supply Return Vent <br /> Pipe Manufacturer Environ Environ Environ <br /> Test Start Time 12:00 12:00 12:00 <br /> Initial Reading 5 5 5 <br /> Test End Time 13:00 13:00 13:00 <br /> Final Reading 5 5 5 <br /> Change in Reading o 0 0 <br /> Pass/Fail Criteria o 1 0 0 <br /> Tightness Test Results ® Pass ❑ Fail N 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 6 <br />