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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 6. SPILL CONTAINER DETAILS <br /> Test Method Developed by Lj Manufacturer �( Industry Standard Professional Engineer <br /> Test Type Pressure Vacuum Hydrostatic <br /> Tank ID TI Fill T2 Fill T3 Fill T4 Fill <br /> Spill Container Manufacturer: oPW OPW oPW oPW <br /> Method of Cathodic Protection ❑✓ Nonmetallic W/ Nonmetallic ZNonmetallic ✓ Nonmetallic <br /> 100ther Other DOther ❑Other <br /> Is the spill container minimum ❑✓ Yes ❑✓ Yes <br /> capacity five gallons excluding ❑✓ Yes ❑✓ Yes <br /> riser volume? No* ::]No* ❑No* ❑No* <br /> Drain Drain Drain ❑Drain <br /> empty y <br /> Method to keep spill container QPump 1/ Pump [Z]Pump [Z]PUMPnp <br /> Other Other Other 00ther <br /> Spill Container Test Results ✓ Pass [Z]Pass ❑✓ Pass OPass <br /> ❑Fail EjFail ❑Fail ❑Fail <br /> Tank ID T1 Vapor T2 Vapor T3 Vapor T4 Vapor <br /> Spill Container Manufacturer: oPW oPW oPW oPW <br /> Method of Cathodic Protection [Z]Nonmetallic ONonmetallic ✓ Nonmetallic �/ Nonmetallic <br /> Other [::]OtherOther ❑Other <br /> Is the spill container minimum ❑✓ Yes ❑✓ Yes ✓ Yes ✓❑Yes <br /> capacity five gallons excluding <br /> riser volume? ❑No* ❑No* ❑No* ❑No* <br /> Method to keep spill container ❑DrainDrain LJDrain ❑7rain <br /> empty QPump Pump ✓❑Pump Epump <br /> Other Other ❑Other ther <br /> Spill Container Test Results ✓[Pass E/ ass ✓ Pass EjPass <br /> ❑Fail Lyail iF7Fail ETail <br /> 8. COMMENTS <br /> Describe all answers marked "Other," "No,"or"Fail"and each proposed remedy. <br /> * Mark here if: <br /> S ill containers do not have a minimum capacRy capacityof five gallons and require replacement. <br /> Additional copies of this page may be attached <br /> Page 2 of 2 <br />