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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 J Professional Engineer <br /> Test Type Ll Pressure ❑ Vacuum bd Hydrostatic <br /> Tank ID REG. REG.#2 PREM. DSL <br /> Spill Container Manufacturer. OPw OPw OPw OPw <br /> Method of Cathodic Protection Nonmetallic R! Nonmetallic 0 Nonmetallic 21 Nonmetallic <br /> ❑ Other D Other ❑ Other ❑ Other <br /> Is the spill container minimum 0 Yes 0 Yes 0 Yes 0 Yes <br /> capacity five gallons excluding ❑ No' ❑ No* ❑ No* ❑ No' <br /> riser volume? <br /> 0 Drain 0 Drain ® Drain Drain <br /> Method to keep spill container ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> empty <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass 0Pass ❑ Pass ® Pass <br /> p C! Fail ❑ Fail ❑ Fail Fail <br /> Tank ID <br /> Spill Container Manufacturer. <br /> Method of Cathodic Protection D Nonmetallic Li Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other LJ Other ❑ Other ❑ Other <br /> Is the spill container minimum g Yes B Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* ❑ No* ❑ No* ❑ No* <br /> riser volume? <br /> ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> Method to keep spill container �j pump D Pump ❑ Pump ❑ Pump <br /> empty LJ Other D Other ❑ Other ❑ Other <br /> Spill Container Test Results LJ Pass D Pass D Pass j Pass <br /> ❑ Fail Cf Fail C Fail ❑ Fail <br /> 8. COMMENTS <br /> Describe all answers marked 'Other.""No,"or"Fail'and each proposed remedy. <br /> * Mark here if: <br /> L] Spill containers do not have a minimum capacity of five gallons and require replacement. <br /> Additional copies of this page may be attached. <br /> Page 2 of 2 <br />