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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 /> ZDrain ❑✓ Drain ❑✓ Drain ❑ Drain <br /> Method to keep spill container El ElPump F] Pump ElPump <br /> empty <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> [Spill Container Test Results ✓❑ Pass ❑✓ Pass ✓❑ Pass ❑ 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 <br /> riser volume? ❑ No* ❑ No* ❑ No* ❑ No* <br /> ❑ Drain El Drain E] Drain ❑ Drain <br /> Method to keep spill container El 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," "No,"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 />