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Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> 6. TANK SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ® Vacuum ❑ Hydrostatic <br /> Test Equipment Used: Vacuum Pump/Vacuum Gauges in Hg. <br /> Tank ID 1-Race 100 2-Super 91 3-Regular 87 4-Dsl-South <br /> Tank Manufacturer CSI CSI CSI CSI <br /> Tank Capacity 10K 10K 12K 20K <br /> Test Start Time 8:50 9:00 9:10 9:20 <br /> Initial Reading -10" Hg. -10" Hg. -10" Hg. -10" Hg. <br /> Test End Time 9:50 10:00 10:10 11:20 <br /> Final Reading -10" Hg. -10" Hg. -10" Hg. -10" Hg. <br /> Change in Reading 0" Hg. 0" Hg. 0" Hg. 0" Hg. <br /> Pass/Fail Criteria No Loss No Loss No Loss No Loss <br /> Tightness Test Results ® Pass ❑ Fail 1 ® Pass ❑ Fail 1 ® Pass ❑ Fail I ® Pass ❑ Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer <br /> Test Type ® Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: Pressure Gauges in Psi/Nitrogen <br /> Pipe Run ID 1-Race 100 2-Super 91 3-Regular 87 4-Diesel <br /> Pipe Manufacturer Smith Smith Smith Smith <br /> Test Start Time 8:35 8:38 8:41 8:44 <br /> Initial Reading 5 Psi 5 Psi 5 Psi 5 Psi <br /> Test End Time 9:35 9:38 9:41 9:44 <br /> Final Reading 5 Psi 5 Psi 5 Psi 5 Psi <br /> Change in Reading 0 Psi 0 Psi 0 Psi 0 Psi <br /> Pass/Fail Criteria No Loss No Loss No Loss No Loss <br /> Tightness Test Results ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail <br /> Pipe Run ID 547-Sat 648-Sat 749-Sat 8410-Sat <br /> Pipe Manufacturer Smith Smith Smith Smith <br /> Test Start Time 11:33 11:36 11:39 11:44 <br /> Initial Reading 5 Psi 5 Psi 5 Psi 5 Psi <br /> Test End Time 12:33 12:36 12:39 12:44 <br /> Final Reading 5 Psi 5 Psi 5 Psi 5 Psi <br /> Change in Reading 0 Psi 0 Psi 0 Psi 0 Psi <br /> Pass/Fail Criteria No Loss No Loss No Loss No Loss <br /> Tightness Test Results ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail <br /> Additional copies of this page may be attached. <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 9 <br />