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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 <br />TA/ Diesel <br />Spill Container Manufacturer: <br />OPW <br />Method of Cathodic Protection <br />® Nonmetallic <br />F] nther <br />ElNonmetallic <br />F-1 Other <br />ElNonmetallic <br />F] Other <br />ElNonmetallic <br />F1 Other <br />Is the spill container minimum <br />capacity five gallons excluding <br />riser volume? <br />® Yes <br />❑ No* <br />❑ Yes <br />❑ No* <br />❑ Yes <br />❑ No* <br />❑ Yes <br />❑ No* <br />Method to keep spill container <br />empty <br />® Drain <br />❑ Pump <br />El Drain <br />❑ Pump <br />El Drain <br />❑ Pump <br />El Drain <br />❑ Pump <br />Spill Container Test Results <br />® Pass <br />El Pass <br />1:1Pass <br />El Pass <br />Tank ID <br />Spill Container Manufacturer: <br />Method of Cathodic Protection <br />ElNonmetallic <br />F1 Other <br />ElNonmetallic <br />F-1 Other <br />ElNonmetallic <br />F-1 Other <br />ElNonmetallic <br />F1 Other <br />Is the spill container minimum <br />capacity five gallons excluding <br />riser volume? <br />i <br />❑ Yes <br />El No* <br />❑ Yes <br />El No* <br />❑ Yes <br />El No* <br />❑ Yes <br />El No* <br />Method to keep spill container <br />empty <br />❑ Drain <br />❑ Pump <br />❑ Drain <br />❑ Pump <br />❑ Drain <br />❑ Pump <br />❑ Drain <br />❑ Pump <br />Spill Container Test Results <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />8. COMMENTS <br />Describe all answers marked "Other, " "No, " or "Fail" and each proposed remedy. <br />Other Cathodic Protection Comments: Other Method Comments: 11 Failure <br />Explanations: Additional Comments: <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 maybe attached. <br />Page 2 of 3 <br />