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Underground Storage Tann <br />Spill Container Testing Report Form <br />6. SPILL CONTAINER DETAILS <br />Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional Engineer <br />Test Type Ll Pressure ❑ Vacuum 0 Hydrostatic <br />Tank ID <br />T1 DSL <br />Spill Container Manufacturer. <br />oPW <br />0 Nonmeta;lic <br />❑ Nonmetallic <br />❑ Nonmetallic <br />❑ nonmetallic <br />Method of Cathodic Protection <br />❑ Other <br />❑ Other <br />❑ Other <br />El Other <br />Is the spill container minimum <br />0 Yes <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />capacity five gallons excluding <br />❑ No* <br />❑ No* <br />❑ No* <br />❑ iso* <br />riser volume? <br />R1 Drain <br />❑ Drain <br />❑ Drain <br />El Drain <br />Method to keep spill container <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />Ll Pump <br />empty <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />Spill Container Test Results <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />Tank la <br />Spill Container Manufacturer - <br />11 Nonmetallic <br />El Nonmetallic <br />El Nonmetallic <br />Met#�od of Cathodic Protection <br />Method <br />❑ Other <br />❑ Other <br />❑ Other <br />Ll Other <br />Is the spill container minimum <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />capacity five gallons excluding <br />❑ No* <br />❑ No* <br />❑ Ido* <br />❑ Ido* <br />riser volume? <br />❑ Drain <br />❑ Drain <br />❑ Drain <br />❑ Drain <br />Method to keep spill container <br />❑ pump <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />empty <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Pass <br />❑ Pass <br />❑ Pass ❑ Pass <br />Spill Container Test Results <br />Q Fail <br />❑ Fail <br />❑ Fail ❑ Fail <br />8. COMMENTS <br />Describe all answers marked ""Other." "No " or "Fail' and each proposed remedy. <br />* Mark here if: <br />❑ Spill containers do not have a minimum capacity of five gaiions and require replacement. <br />Additionef copies of this page maybe attached. <br />Page 2 of 2 <br />