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<br />Underground Storage Tank <br />Spill Container Testing Report Form <br />Additional copies of this page may be attached. <br /> <br />Page 2 of 2 <br />6. SPILL CONTAINER DETAILS <br /> <br />Test Method Developed by ☐☐☐☐ Manufacturer ☒☒☒☒ Industry Standard ☐☐☐☐ Professional Engineer <br />Test Type ☐☐☐☐ Pressure ☐☐☐☐ Vacuum ☒☒☒☒ Hydrostatic <br /> <br />Tank ID 1#-Regular #2-Premium #3-Diesel <br />Spill Container Manufacturer: Phil-tite Phil-tite Phil-tite <br />Method of Cathodic Protection ☒☒☒☒ Nonmetallic <br />☐☐☐☐ Other <br />☒☒☒☒ Nonmetallic <br />☐☐☐☐ Other <br />☒☒☒☒ Nonmetallic <br />☐☐☐☐ Other <br />☐☐☐☐ Nonmetallic <br />☐☐☐☐ Other <br />Is the spill container minimum <br />capacity five gallons excluding <br />riser volume? <br />☒☒☒☒ Yes <br />☐☐☐☐ No* <br />☒☒☒☒ Yes <br />☐☐☐☐ No* <br />☒☒☒☒ Yes <br />☐☐☐☐ No* <br />☐☐☐☐ Yes <br />☐☐☐☐ No* <br />Method to keep spill container <br />empty <br />☒☒☒☒ Drain <br />☐☐☐☐ Pump <br />☐☐☐☐ Other <br />☒☒☒☒ Drain <br />☐☐☐☐ Pump <br />☐☐☐☐ Other <br />☒☒☒☒ Drain <br />☐☐☐☐ Pump <br />☐☐☐☐ Other <br />☐☐☐☐ Drain <br />☐☐☐☐ Pump <br />☐☐☐☐ Other <br />Spill Container Test Results ☐☐☐☐ Pass <br />☒☒☒☒ Fail <br />☒☒☒☒ Pass <br />☐☐☐☐ Fail <br />☒☒☒☒ Pass <br />☐☐☐☐ Fail <br />☐☐☐☐ Pass <br />☐☐☐☐ Fail <br /> <br />Tank ID <br />Spill Container Manufacturer: <br />Method of Cathodic Protection ☐☐☐☐ Nonmetallic <br />☐☐☐☐ Other <br />☐☐☐☐ Nonmetallic <br />☐☐☐☐ Other <br />☐☐☐☐ Nonmetallic <br />☐☐☐☐ Other <br />☐☐☐☐ Nonmetallic <br />☐☐☐☐ Other <br />Is the spill container minimum <br />capacity five gallons excluding <br />riser volume? <br />☐☐☐☐ Yes <br />☐☐☐☐ No* <br />☐☐☐☐ Yes <br />☐☐☐☐ No* <br />☐☐☐☐ Yes <br />☐☐☐☐ No* <br />☐☐☐☐ Yes <br />☐☐☐☐ No* <br />Method to keep spill container <br />empty <br />☐☐☐☐ Drain <br />☐☐☐☐ Pump <br />☐☐☐☐ Other <br />☐☐☐☐ Drain <br />☐☐☐☐ Pump <br />☐☐☐☐ Other <br />☐☐☐☐ Drain <br />☐☐☐☐ Pump <br />☐☐☐☐ Other <br />☐☐☐☐ Drain <br />☐☐☐☐ Pump <br />☐☐☐☐ Other <br />Spill Container Test Results ☐☐☐☐ Pass <br />☐☐☐☐ Fail <br />☐☐☐☐ Pass <br />☐☐☐☐ Fail <br />☐☐☐☐ Pass <br />☐☐☐☐ Fail <br />☐☐☐☐ Pass <br />☐☐☐☐ Fail <br />1 <br />8. COMMENTS <br />Describe all answers marked “Other,” “No,” or “Fail” and each proposed remedy. <br />Inspector on site. <br />Note that the Regular Fill Spill bucket FAILED due to a BAD Fill swivel. It needs to be <br />replaced then bucket retested. <br /> <br /> <br /> <br /> <br /> <br />* Mark here if: ☐ Spill containers do not have a minimum capacity of five gallons and require <br />replacement. <br />