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Underground Storage Tank Spill Container Testing Report Form 6. SPILL CONTAINER DETAILS Test Method Developed by ® Manufacturer ® Industry Standard ❑ Professional Engineer Test Type ❑ Pressure ❑ Vacuum ® 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 DSL CNI ® Nonmetallic R7 Other ® Yes ❑ No* ® Drain ❑ Pump 0 Other M Pass ❑ Fail 87-1 CNI ® Nonmetallic T1 Other ® Yes ❑ No* F1 Drain ❑ Pump ❑ Other ® Pass ❑ Fail 87-2 CNI M Nonmetallic ❑ Other ® Yes No* ® Drain ❑ Pump ❑ Other F1 Pass ❑ Fail 91 OPW ® Nonmetallic ❑ Other Q Yes ❑ No* ® Drain ❑ Pump ❑ Other ® Pass ri Fail Spill Container Manufacturer: Method of Cathodic Protection ® Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Other ® Other ® Other ® Other Is the spill container minimum capacity five gallons excluding ® Yes ❑ Yes ❑ Yes ® Yes riser volume? ®No* L-1No* ❑ No* F7 No* Method to keep spill container ® Drain ❑ Drain ® Drain ® Drain empty ® Pump ❑ Pump ❑ Pump ® Pump ❑ Other ❑ Other ❑ Other ❑ Other Spill Container Test Results ® Pass ❑ Pass ❑ Pass �17 ❑ Pass ® Fail ❑ Fail ® Fail 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 replacement Additional copies of this page may be attached. Page 2 of 2