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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> p Y L� Manufacturer ® Industry Standard -.:... ,: ., -.z: <br /> Test Method Develo ed b « ® Professional Engineer <br /> Test Type ® Pressure ® Vacuum ® Hydrostatic <br /> Spill Container Manufacturer: <br /> Method of Cathodic Protection onmetallic onmetallic fonmetallic ® Nonmetallic <br /> ® Other ® Other ® Other ® Other <br /> Is the spill container minimum N� ��/ ,� <br /> capacity five gallons excluding l '�s es M," es ® Yes <br /> riser volume? ® ® No r_°1 NO* ® No* <br /> Method to keep spill container ® Drain ® Drain C Drain ® Drain <br /> empty 6�tler mp ® Pump ® P np Pump <br /> r ® Pass <br /> r ® Other <br /> Spill Container Test Results - ass ass ® Pass <br /> ® Fail ® Fail ® Fail ® Fail <br /> Tank ID <br /> Spill Container Manufacturer: OPW OPW OPW <br /> Method of Cathodic Protection ® Nonmetallic ® Nonmetallic ® Nonmetallic ® Nonmetallic <br /> Other ® Other ® Other U Other <br /> Is the spill container minimum El <br /> capacity five gallons excluding ® Yes El Yes ® Yes ® Yes <br /> riser volume? ® No* r] No's ® No* r No* <br /> Method to keep spill container ® Drain ® Drain ® Drain ® Drain <br /> empty ® Pump LI Pump ® Pump ® Pump <br /> ® Other ® Other ® Other ® Other <br /> Spill Container Test Results ® Pass ® Pass ® Pass El Pass <br /> ® Fail EI Fail ® Fail i <br /> GQ�VIIIENT�, � '� <br /> Describe all answers marked "Other," "No "or"Farl"and each <br /> ._. ..... <br /> > p p ro ase d re medy. <br /> * Mark here if: <br /> ® S ill containers do not have a minimum capacity of five gallons and require re iacement. <br /> Additional copies of this page may be attached. <br /> Page 2 of 2 <br />