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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> £. SPILL CONTAINER DETAkIL. <br /> Test Method Developed by ® Manufacturer p Industry Standard El Professional Engineer <br /> Test Type 0 Pressure ❑ Vacuum ❑ Hydrostatic <br /> Tank 1D 67 91 DL <br /> Spill Container Manufacturer: OPW OPW OP <br /> Method of Cathodic Pmtection ® Nonmetallic i El Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ® Other ❑ Other ❑ Other Other <br /> Is the spill container minimum E) Yes E Yes M Yes Yes <br /> capacity five gallons excluiding T] No* ❑ No. ❑ No. ❑ No* <br /> riser volume? <br /> etl o <br /> d to keep spill con#ainer E) Drain 0 Drain ❑ Drain E) Drain <br /> N1echo <br /> M 17] Pump R7 Pump E] Pump 17 Pump <br /> ® Other ❑ Other ❑ Other 0 Other <br /> Spill Container Test Results ® Pass m Pass Pass E) Pass <br /> ❑ Fail I ❑ Fail ] Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> Method of Cathodic Protection ❑ Nonmetailic r] Nonmetallic El Nonmetallic ❑ Nonmetallic <br /> ❑ Other C Other Cp Other 17 Other <br /> Is the spill container minimum <br /> ❑ Yes E) Yes ❑ Yes CI Yes <br /> capacity five gallons excluding ❑ o* T] No* ❑ No* ❑ No* <br /> riser volume? <br /> Method to keep spill container ❑ Drain ❑ gain n Drain ❑ Drain <br /> empty ❑ Pump 0 Pump pj Pump ❑ Pump <br /> ❑ Other ❑ Other ❑ Other .[I__Other <br /> Spill Container Test results ❑ Pass U Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ID Fail ❑ Fail <br /> . COMMENTS <br /> _. <br /> Describe aIf answers marked "Other R "No," or 'Fail" and each proposed remedy. <br /> Mark here if: <br /> ❑ Spill containers do not have a minimum capacity of five gallons and require replacement- <br /> Additional <br /> e lacement_Additional copies of this page may be a#taohed. <br /> Page 2 of <br />