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Underground Storage Tank Secondary Containment Testing Report Form 16. TANK SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional Engineer Test Type ❑ Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used: 0-30 HG Gauges Tank ID 87 91 / Diesel Test Equipment Used: o-10 PSI Gauges Tank Manufacturer Modern Welding Modern Welding 91 Tank Capacity 20,000 20,000 NOV Smith Test Start Time 10:00 am 10:00 am 1:00 pm Initial Reading 10 hg 10 hg Initial Reading Test End Time 11:00 am 11:00 am 5 psi Final Reading 10 hg 10 hg 2:00 pm Change in Reading 0 0 5 psi Pass/Fail Criteria 0 0 0 Tightness Test Results 0 Pass ❑ Fail 0 Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail 7. PIPE SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer ❑ Industry Standard ❑ Professional Engineer Test Type 0 Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used: o-10 PSI Gauges Pipe Run ID 87 East 87 West 91 Diesel Pipe Manufacturer NOV Smith NOV Smith NOV Smith NOV Smith Test Start Time 1:00 pm 1:00 pm 1:00 pm 1:00 pm Initial Reading 5 psi 5 psi 5 psi 5 psi Test End Time 2:00 pm 2:00 pm 2:00 pm 2:00 pm Final Reading 5 psi 5 psi 5 psi 5 psi Change in Reading 0 0 0 0 Pass/Fail Criteria 0 0 0 0 Tightness Test Results 0 Pass ❑ Fail 0 Pass ❑ Fail 0 Pass ❑ Fail 0 Pass ❑ Fail Pipe Run ID Pipe Manufacturer Test Start Time Initial Reading Test End Time Final Reading Change in Reading Pass/Fail Criteria 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 2of5