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Underground Storage Tank Secondary Containment Testing Report Form 6. TANK SECONDARY CONTAINMENT TEST Test Method Developed by H Manufacturer H Industry Standard ❑ Professional Engineer Test Type ❑ Pressure H Vacuum ❑ Hydrostatic Test Equipment Used: 0-30inHg. 4" Vacuum Gauges w/ 0.05 graduations Tank ID T-1 DSL Product T-2 87 Product T-3 91 Product Tank Manufacturer A.O. Smith A.O. Smith A.O. Smith Tank Capacity 9:00am 9:00am 9:00am Test Start Time 5psi 5psi 5psi Initial Reading 10:00am 10:00am 10:00am Test End Time 5psi 5psi 5psi Final Reading 0.00 0.00 0.00 Change in Reading No Loss No Loss No Loss No Loss Pass/Fail Criteria No Loss No Loss No Loss No Loss Tightness Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail 7. PIPE SECONDARY CONTAINMENT TEST Test Method Developed by H Manufacturer H Industry Standard ❑ Professional Engineer Test Type H Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used: Dual 0-15psi 4" Pressure Gauges w/ 0.05 graduations Pipe Run ID T-1 DSL Product T-2 87 Product T-3 91 Product Pipe Manufacturer A.O. Smith A.O. Smith A.O. Smith Test Start Time 9:00am 9:00am 9:00am Initial Reading 5psi 5psi 5psi Test End Time 10:00am 10:00am 10:00am Final Reading 5psi 5psi 5psi Change in Reading 0.00 0.00 0.00 Pass/Fail Criteria No Loss No Loss No Loss No Loss Tightness Test Results H Pass ❑ Fail H Pass ❑ Fail H Pass ❑ Fail ❑ Pass ❑ Fail Pipe Run ID Pipe Manufacturer Test Start Time Initial Reading Test End Time Final Reading Change in Reading Pass/Fail Criteria No Loss No Loss No Loss No Loss Tightness Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail All tests marked "Fail' and any repairs made before or during the tightness test must be described in the COMMENTS section. Page 2of5