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Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> Test Method Developed by ❑ Manufacturer ❑ Industry Standard x Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum x Hydrostatic <br /> Test Equipment Used:Caldwell Level Change Indicator <br /> Sump/UDC ID UDC 1&2 UDC3&4 UDC5&6 UDC 7&8 <br /> Sump Manufacturer Western Western Western Western <br /> Sump Depth (inches) 32 1/2" 33 1/2" 32 1/2" 32 1/2" <br /> Sump Bottom to Top of 9" 9" 9" 9" <br /> Highest Pipe Penetration <br /> (inches) <br /> Test Start Time 9:32 a.m. 9:26 a.m. 9:11 a.m. 10:16 a.m. <br /> Initial Reading .001 .001 .001 .001 <br /> Test End Time 10:02 a.m. 9:56 a.m. 9:41 a.m. 10:46 a.m. <br /> Final Reading .001 .001 .001 .001 <br /> Change in Reading 0 0 0 0 <br /> Pass/Fail Criteria .005130 min. .005/30 min. .005130 min. .005/30 min. <br /> Tightness Test Results x Pass Fail x Pass Fail x Pass Fail x Pass Fail <br /> Sump1UDC ID UDC # 9&10 UDC 11&12 87 STP SUMP 87 SYP SUMP <br /> Sump Manufacturer Western Western XERXES XERXES <br /> Sump Depth (inches) 33" 32" 75 " 76" <br /> Sump Bottom to Top of 9" 9" 52 1/2" 50" <br /> Highest Pipe Penetration <br /> (inches) <br /> Test Start Time 10:10 a.m. 10:22 a.m. 12:25 p.m. 11:30 a.m. <br /> Initial Reading .001 .001 .001 .001 <br /> Test End Time 10:40 a.m. 10:52 a.m. 12:55 p.m. 12:00 p.m. <br /> Final Reading 0.001 .001 .001 .001 <br /> Change in Reading 0 0 0 0 <br /> Pass/Fail Criteria .005130 min. .005130 min. .005/30 min. .005/30 min. <br /> Tightness Test Results x Pass Fail x Pass Fail x Pass Fail x 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 3of5 <br />