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Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> Test Method Developed by ❑ Manufacturer ❑ Industry Standard X Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum X Hydrostatic <br /> Test Equipment Used : Cadwell Level Indicator, test fluid ( H20) <br /> Sump/UDC ID Super stp Regular stp Diesel stp Super fill <br /> Sump Manufacturer unknown unknown unknown unknown <br /> Sump Depth (inches) 63 63 63 59 <br /> Sump Bottom to Top of 23 23 23 10 <br /> Highest Pipe Penetration <br /> (inches) <br /> Test Start Time 30 minutes 30 minutes 30 minutes 30 minutes <br /> Initial Reading first circle first circle first circle first circle <br /> Test End Time 0 minute 0 minute 0 minute 0 minutes <br /> Final Reading no change no change no change no change <br /> Change in Reading 0 0 0 0 <br /> Pass/Fail Criteria 0.002/30min 0. 002/30mins 0.002130mins 0.002/30mins <br /> Tightness Test Results X Pass ❑ Fail X Pass ❑ Fail X Pass ❑ Fail X Pass ❑ Fail <br /> Sump/UDC ID Regular fill Diesel fill udc 1 =2 udc 34 <br /> Sump Manufacturer unknown unknown unknown unknown <br /> Sump Depth (inches) 59 58 30 30 <br /> Sump Bottom to Top of 10 10 14 14 <br /> Highest Pipe Penetration <br /> (inches) <br /> Test Start Time 30 minutes 30 minutes 30 minutes 30 minutes <br /> Initial Reading first circle first circle first circle first circle <br /> Test End Time 0 minutes 0 minutes 0 minutes 0 minutes <br /> Final Reading no change no change no change no change <br /> Change in Reading 0 0 0 0 <br /> Pass/Fail Criteria 0 .002/30mins 0.002/30mins 0.002/30mins 0.002/30mins <br /> Tightness Test Results X Pass ❑ Fail X Pass ❑ Fail X Pass ❑ Fail X 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 3 of 5 <br />