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Underground Storage Tank <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 0 Vacuum LJ Hydrostatic <br /> Tank IC REG. PREM. DSL <br /> Spill Container Manufacturer. oPW oPW oPW <br /> Method of Cathodic Protection 0 Nonmetallic 0 Nonmetallic 0 Nonmetallic ❑ nonmetallic <br /> ❑ Other ❑ Other ❑ Other El Other <br /> Is the spill container minimum 0 Yes 0 Yes R1 Yes ❑ Yes <br /> capacity five gallons excluding <br /> ❑ Na* ❑ No* ❑ No* ❑ No" <br /> riser volume? <br /> R1 Drain R) Drain R1 Drain El Drain <br /> Method to keep spill container ❑ Pump ❑ Pump LJ Pump LJ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank IC <br /> SpiJI Container Manufacturer: <br /> ❑ Nonmetallic F Nonmetallic El Nonmetallic Ej Nonmetallic <br /> Method of Cathodic Protection ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ❑ yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* ❑ No* ❑ No* ❑ No* <br /> riser volume? <br /> ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> Method to keep spill container ❑ pump ❑ Pump ❑ Pump ❑ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> Q Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8. COMMENTS <br /> Describe all answers marked 'Other,`No,"yNo,"or"Fart'and each proposed remedy, <br /> *Mark here if: <br /> ❑ Spill containers do not have a minimum capacity of five gailions and require replacement. <br /> Additionef copies of this page maybe attached. <br /> Page 2 of 2 <br />