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Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> 6. TANK SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer © Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure © Vacuum ❑ Hydrostatic <br /> Test Equipment Used: Vacuum Pump/Vacuum Gauges in Hg. <br /> Tank ID 1-Diesel 2-Diesel 3-87 4-91/87 <br /> Tank Manufacturer Modern Wld Modern Wld Modern Wld Modern Wld <br /> Tank Capacity 20K 20K 20K 20K 2 Compt <br /> Test Start Time 8:50 9:00 9:10 9:20 <br /> Initial Reading -10" Hg. -10" Hg. -10" Hg. -10" Hg. <br /> Test End Time 10:50 11:00 11:10 11:20 <br /> Final Reading -10" Hg. -10" Hg. -10" Hg. -10" Hg. <br /> Change in Reading 0" Hg. 0" Hg. 0" Hg. 0" Hg. <br /> Pass/Fail Criteria No Loss No Loss No Loss No Loss <br /> Tightness Test Results ® Pass ❑ Fail I ® Pass ❑ Fail ® Pass ❑ Fail I ® Pass ❑ Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer <br /> Test Type ® Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: Pressure Gauges in Psi/Nitrogen <br /> Pipe Run ID 1-Diesel 2-Diesel 3-Regular 87 4-Super 91 <br /> Pipe Manufacturer Smith Smith Smith Smith <br /> Test Start Time 12:35 12:38 12:41 12:44 <br /> Initial Reading 5 Psi 5 Psi 5 Psi 5 Psi <br /> Test End Time 1:35 1:38 1:41 1:44 <br /> Final Reading 5 Psi 5 Psi 5 Psi 5 Psi <br /> Change in Reading 0 Psi 0 Psi 0 Psi 0 Psi <br /> Pass/Fail Criteria No Loss No Loss No Loss No Loss <br /> Tightness Test Results © Pass ❑ Fail © Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail <br /> Pipe Run ID 5-Dsl-Siphon 6-Dsl-Manifl 7-Dsl-Auto 8-87-Siphon <br /> Pipe Manufacturer Smith Smith Smith Smith <br /> Test Start Time 12:33 12:30 12:28 12:48 <br /> Initial Reading 5 Psi 5 Psi 5 Psi 5 Psi <br /> Test End Time 1:33 1:30 1:28 1:48 <br /> Final Reading 5 Psi 5 Psi 5 Psi 5 Psi <br /> Change in Reading 0 Psi 0 Psi 0 Psi 0 Psi <br /> Pass/Fail Criteria No Loss No Loss No Loss No Loss <br /> Tightness Test Results © Pass ❑ Fail © Pass ❑ Fail ® Pass ❑ Fail ® 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 2 of 9 <br />