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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 6. SPILL CONTAINER DETAILS <br /> Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional Engineer <br /> Test Type Ll Pressure 0 Vacuum LJ Hydrostatic <br /> Tank ID T1 REG T2 PREM T3 DIESEL <br /> Spill Container Manufacturer. oPW oPW oPW <br /> Method of Cathodic Protection 0 Nonmeta;lic 0 Nonmetallic R1 Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other El Other <br /> Is the spill container minimum 0 Yes 0 Yes R1 Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* ❑ Ido* ❑ No* ❑ iso* <br /> riser volume? <br /> R1 Drain R1 Drain R1 Drain D Drain <br /> Method to keep spill container ❑ Pump ❑ Pump ❑ Pump LJ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass 2 Pass ❑ Pass <br /> ❑ Fail I ❑ Fail I ❑ Fail L❑ Fail <br /> Tank la <br /> Spill Container Manufacturer- <br /> Method E) Nonmetallic El Nonmetallic El Nonmetallic <br /> Met#�od of Cathodic Protection ❑ Other ❑ Other ❑ Other Ll Other <br /> Is the spill container minimum ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* ❑ No* ❑ Ido* ❑ Ido* <br /> riser volume? <br /> ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> Method to keep spill container ❑ pump ❑ Pump ❑ Pump ❑ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> Q 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 galions and require replacement. <br /> Additional copies of this page maybe attached. <br /> Page 2 of 2 <br />