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Underground Storage Tank <br />Secondary Containment Testing Report Form <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 2 of 5 <br />Test Method Developed by Manufacturer Industry Standard Professional Engineer <br />Test Type Pressure Vacuum Hydrostatic <br />Test Equipment Used: <br />Tank ID <br />Tank Manufacturer <br />Tank Capacity <br />Test Start Time <br />Initial Reading <br />Test End Time <br />Final Reading <br />Change in Reading <br />Pass/Fail Criteria <br />Tightness Test Results Pass Fail Pass Fail Pass Fail Pass Fail <br />Test Method Developed by Manufacturer Industry Standard Professional Engineer <br />Test Type Pressure Vacuum Hydrostatic <br />Test Equipment Used: <br />Pipe Run ID <br />Pipe Manufacturer <br />Test Start Time <br />Initial Reading <br />Test End Time <br />Final Reading <br />Change in Reading <br />Pass/Fail Criteria <br />Tightness Test Results Pass Fail Pass Fail Pass Fail Pass Fail <br />Pipe Run ID <br />Pipe Manufacturer <br />Test Start Time <br />Initial Reading <br />Test End Time <br />Final Reading <br />Change in Reading <br />Pass/Fail Criteria <br />Tightness Test Results Pass Fail Pass Fail Pass Fail Pass Fail <br />Additional copies of this page may be attached. <br />6. TANK SECONDARY CONTAINMENT TEST <br />7. PIPE SECONDARY CONTAINMENT TEST <br />87 UNLEADED <br />NOV/SMITH <br />10:00 AM <br />5 PSI <br />11:00 AM <br />5 PSI <br />0 PSI <br />0 PSI <br />91 PREMIUM <br />NOV/SMITH <br />10:00 AM <br />5 PSI <br />11:00 AM <br />5 PSI <br />0 PSI <br />0 PSI <br />DIESEL <br />NOV/SMITH <br />10:00 AM <br />5 PSI <br />11:00 AM <br />5PSI <br />0 PSI <br />0PSI