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Underground Storage Tank Spill Container Testing Report Form 6. SPILL CONTAINER DETAILS Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional Engineer Test Type ❑ Pressure ❑ Vacuum Q Hydrostatic Tank ID Spill Container Manufacturer: Method of Cathodic Protection Is the spill container minimum capacity five gallons excluding riser volume? Method to keep spill container empty Spill Container Test Results Tank ID OPW 0 Nonmetallic ❑ Other El Yes ❑ No* 17 Drain ❑ Pump ❑ Other O Pass ❑ Fail 1 OPW 1`71 Nonmetallic ❑ Other El Yes ❑ No* 0 Drain ❑ Pump ❑ Other El Pass ❑ Fail DIESEL El Nonmetallic ❑ Other El Yes ❑ No* 0 Drain ❑ Pump ❑ Other El Pass ❑ Fail ❑ Nonmetallic ❑ Other ❑ Yes ❑ No* ❑ Drain ❑ Pump ❑ Other ❑ Pass ❑ Fail 11 Spill Container Manufacturer: I I I 1 11 Method of Cathodic Protection ❑ Nonmetallic ❑ Other Is the spill container minimum ❑ Yes capacity five gallons excluding C-1 No* riser volume? Method to keep spill container E3 Drain empty ❑ pump ❑ Other Spill Container Test Results ❑ Pass ❑ Fail ❑ Nonmetallic ❑ Other ❑ Yes ❑ No* ❑ Drain ❑ Pump ❑ Other ❑ Pass ❑ Fail ❑ Nonmetallic ❑ Other ❑ Yes ❑ No* ❑ Drain ❑ Pump ❑ Other ❑ Pass ❑ Fail 8. COMMENTS Describe all answers marked "Other, " "No, " or "Fail' and each proposed remedy. * Mark here if: ❑ Spill containers do not have a minimum capacity of five gallons and require Additional copies of this page may be attached. ❑ Nonmetallic ❑ Other ❑ Yes ❑ No* ❑ Drain ❑ Pump ❑ Other ❑ Pass ❑ Fail ment. Page 2 of 2