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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 6. SPILL CONTAINER DETAILS <br /> Test Method Developed by ❑ Manufacturer R1 Industry Standard ❑ Professional Engineer j <br /> Test Type ❑ Pressure ❑ Vacuum LJ Hydrostatic <br /> Tank ID T1 87 T2 91 T3 DSL <br /> Spill Container Manufacturer: Opw Opw Opw <br /> Method of Cathodic Protection 0 Nonmetallic ® Nonmetallic 0 Nonmetallic D Nonmetallic <br /> ❑ Other ❑ Other ❑ Other J Other <br /> Is the spill container minimum 0 Yes A Yes bd Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* ❑ No* ❑ No* ❑ No* <br /> riser volume? <br /> Drain A Drain ® Drain LJ Drain <br /> Method to keep spill container ❑ pump LJ Pump LJ Pump ❑ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results 0 Pass ❑ Pass ❑ Pass D Pass <br /> ❑ Fail R] Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> Method of Cathodic Protection [J_ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic J Nonmetallic <br /> ❑ Other ❑ Other ❑ Other J Other <br /> Is the spill container minimum El Yes ❑ Yes ❑ Yes LJ Yes <br /> capacity five gallons excluding ❑ No* ❑ No* ❑ No* ❑ No* <br /> riser volume? <br /> Method to keep spill container ❑ Drain ❑ Drain ❑ Drain LJ Drain <br /> empty ❑ Pump ❑ Pump ❑ Pump LJ Pump <br /> C Other ❑ Other ❑ Other LJ Other <br /> Spill Container Test Results ❑ Pass D Pass ❑ Pass J Pass <br /> ❑ Fail ❑ Fail ❑ Fail J Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other,""No,"or"Fail'and each proposed remedy. <br /> 91 spill bucket failed there is a tear in lower quadrant os spill bucket. <br /> i <br /> i <br /> * Mark here if: <br /> (] Spill containers do not have a minimumGapacity of five gallons and require replacement. <br /> Additional copies of this page may be attached. <br /> Page 2 of 2 <br />