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Underground Storage Tank Secondary Containment Testing Report Form 6. TANK SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer M Industry Standard ❑ Professional Engineer Test Type ❑ Pressure M Vacuum ❑ Hydrostatic Test Equipment Used: Vacuum Gauge Tank ID 87-1 Annular 87-2 Annular 91 Annular Tank Manufacturer Unknown Unknown Unknown Tank Capacity 12000 Gal 12000 Gal 12000n Gal Test Start Time 9:10 AM 9:30 AM 9:50 AM Initial Reading 7 HG 7 HG 7 HG Test End Time 10:10 AM 10:30 AM 10:50 AM Final Reading 7 HG 7 HG 7 HG Change in Reading 0 HG 0 HG 0 HG Pass/Fail Criteria 0 HG 0 HG 0 HG Tightness Test Results M Pass ❑ Fail M Pass ❑ Fail I M Pass ❑ Fail ❑ Pass ❑ Fail 7. PIPE SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer M Industry Standard ❑ Professional Engineer Test Type M Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used: Pressure Gauge Pipe Run ID 87-1 Product 87-2 Product 91 Product Pipe Manufacturer AO Smith AO Smith AO Smith Test Start Time 8:50 AM 8:50 AM 8:50 AM Initial Reading 5 PSI 5 PSI 5 PSI Test End Time 9:50 AM 9:50 AM 9:50 AM Final Reading 5 PSI 5 PSI 5 PSI Change in Reading 0 PSI 0 PSI 0 PSI Pass/Fail Criteria 0 PSI 0 PSI 0 PSI Tightness Test Results M Pass ❑ Fail M Pass ❑ Fail M Pass ❑ Fail ❑ Pass ❑ Fail Pipe Run ID 87-1 Vent 87-2 Vent 91 Vent Vapor Return Pipe Manufacturer AO Smith AO Smith AO Smith AO Smith Test Start Time 8:55 AM 8:55 AM 8:55 AM 8:55 AM Initial Reading 5 PSI 5 PSI 5 PSI 5 PSI Test End Time 9:55 AM 9:55 AM 9:55 AM 9:55 AM Final Reading 5 PSI 5 PSI 5 PSI 5 PSI Change in Reading 0 PSI 0 PSI 0 PSI 0 PSI Pass/Fail Criteria 0 PSI 0 PSI 0 PSI 0 PSI Tightness Test Results M Pass ❑ Fail M Pass ❑ Fail M Pass ❑ Fail M Pass ❑ Fail Additional copies of this page may be attached. All tests marked "Fail"and any repairs made before or during the tightness test must be described in the COMMENTS section. Page 2 of 5