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Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> 6. TANK SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer © Industry Standard d Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used- PEI-RP1 240-Vac-10Hg/1 hr <br /> Tank ID 87191ID L <br /> Tank Manufacturer NIA <br /> Tank Capacity NIA <br /> Test Start Time 10:11 <br /> Initial Reading -10 <br /> Test End Time 11:11 <br /> Final Reading -10 <br /> Change in Reading 0 <br /> Pass/Fail Critena 0 0 0 0 <br /> Tightness Test Results ❑ Pass 17 Fall U Pass ❑ Fail El Pass 17 Fail 0 Pass Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer E] Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: PEI-RP1 00-Press- psi/1hr <br /> Pipe Run ID 87 SED LINE 91 SEG LINE DSL <br /> Pipe Manufacturer NIA NIA NIA <br /> Test Start Time 10:49 11:26 9:30 <br /> Initial Reading 5 5 <br /> Test End Time 11.49 12:26 10:30 <br /> Final Reading 5 5 5 <br /> Change in Reading 0 0 0 <br /> Pass/Fail Criteria 0 0 0 0 <br /> Tightness Test Results Pass ❑ Pail ❑ Pass ❑ Fail Pass 0 Pall RI Pass ❑ Fail <br /> Pipe Run ID <br /> Pipe Manufacturer <br /> Test Start Time <br /> Initiai Reading <br /> Test End Time <br /> Final Reading <br /> Charge in Reading - <br /> Pass/Fail Criteria 0 0 0 <br /> Tightness Test Results Pass [l Fail Pass Ij Fall Pass rl Fail [) Pass ❑ Fail <br /> Additional copies of this page may be attached_ <br /> All tests marked "Fail" and any repairs mare before or during the ti hWess test must be desvr bed in <br /> the CpAR ENTS section. <br /> Page 2 of 5 <br />