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Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> 6. TANK SECONDARY CONTAINMENT TEST <br /> Test Method Developed by [C] Manufacturer E] Industry Standard © Professional Engineer <br /> Test Type 7 Pressure ❑ Vacuum Q 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 0 Pass 0 Fail 0 Pass E Fail 0 Pass 0 Fail ❑ Pass C Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by Manufacturer © Industry Standard © Professional Engineer <br /> Test Type © Pressure 0 Vacuum © Hydrostatic <br /> Test Equipment Used: Pressure Gages <br /> Pipe Run ID Gasoline-87 Gasoline-91 <br /> Pipe Manufacturer Smith Smith <br /> Test Start Time 10:30 10:30 <br /> Initial Reading 5 5 <br /> Test End Time 11:30 11:30 <br /> Final Reading 5 5 <br /> Change in Reading 0 0 <br /> Pass/Fail Criteria 0 0 <br /> Tightness Test Results Pass © Fail 0 Pass r] 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 0 Pass 0 Fail C Pass © Fail P7 Pass © Fail C Pass 0 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 5 <br />