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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 6. SPILL CONTAINER DETAILS <br /> Test Method Developed by ❑✓ Manufacturer ❑ Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum ❑✓ Hydrostatic <br /> Tank ID Tank 1 Regular Tank 2 Premium Tank 3 Diesel <br /> Spill Container Manufacturer: oPw oPw oPw <br /> Method of Cathodic Protection <br /> ❑✓ Nonmetallic ❑✓ Nonmetallic ❑✓ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ 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 ❑✓ Drain ❑✓ Drain ❑✓ Drain ❑ Drain <br /> empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> ❑ Other ❑Other ❑Other ❑ Other <br /> Spill Container Test Results ZPass ZPass ZPass [j Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> Method of Cathodic Protection ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding No* No* No* No* <br /> riser volume? E] No* ❑ ❑ <br /> ❑ Drain El Drain E] Drain E] Drain <br /> Method to keep spill container EJPump ElPump ElPump ElPump <br /> empty <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other," 'Wo,"or "Fail"and each proposed remedy. <br /> * Mark here if: <br /> ❑ Spill containers do not have a minimum capacity of five gallons and require replacement. <br /> Additional copies of this page may be attached. <br /> Page 2 of 2 <br />