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Underground Storage Tank Secondary Containment Testing Report Form 6. TANK SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer Test Type ❑ Pressure ® Vacuum ❑ Hydrostatic Test Equipment Used: Vacuum Pump/Vacuum Gauge in Hg. Tank ID 5-Dsl-North Tank Manufacturer CSI Tank Capacity 20K Test Start Time 9:30 Initial Reading -10" Hg. Test End Time 11:30 Final Reading -10" Hg. Change in Reading 0" Hg. Pass/Fail Criteria No Loss Tightness Test Results ® Pass ❑ Fail I ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail 7. PIPE SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer Test Type ® Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used: Pressure Gauges in Psi/Nitrogen Pipe Run ID 9411-Sat 10412-Sat 11413-Sat 12414-Sat Pipe Manufacturer Smith Smith Smith Smith Test Start Time 11:46 11:49 12:43 12:46 Initial Reading 5 Psi 5 Psi 5 Psi 5 Psi Test End Time 12:46 12:49 1:43 1:46 Final Reading 5 Psi 5 Psi 5 Psi 5 Psi Change in Reading 0 Psi 0 Psi 0 Psi 0 Psi Pass/Fail Criteria No Loss No Loss No Loss No Loss Tightness Test Results ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail Pipe Run ID 13-Gas Vapor 14-Race Vent 15-91 Vent 16-87 Vent Pipe Manufacturer Smith Smith Smith Smith Test Start Time 8:43 9:16 9:18 9:21 Initial Reading 5 Psi 5 Psi 5 Psi 5 Psi Test End Time 9:43 10:16 10:18 10:21 Final Reading 5 Psi 5 Psi 5 Psi 5 Psi Change in Reading 0 Psi 0 Psi 0 Psi 0 Psi Pass/Fail Criteria No Loss No Loss No Loss No Loss Tightness Test Results ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail Additional copies of this page may be attached. All tests marked "Fail"and any repairs made before or during the tightness test must be described in the COMMENTS section. Page 3of 9