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Underground Storage Tank Secondary Containment Testing Report Form 6. TANK SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional Engineer Test Type ❑ Pressure 0 Vacuum ❑ Hydrostatic Test Equipment Used:0-30 inHG Vacuum Gauges Tank ID 87 911 Diesel Tank Manufacturer Modern Welding Modern Welding Tank Capacity 20,000 20,000 Test Start Time 11:15 am 11:15 am Initial Reading 10 hg 10 hg Test End Time 12:15 pm 12:15 pm Final Reading 10 hg 10 hg Change in Reading 0 0 Pass/Fail Criteria 0 0 Tightness Test Results 0 Pass ❑ Fail 0 Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail -11 7. PIPE SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional Engineer Test Type 0 Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used:0-10 PSI Gauges Pipe Run ID 87 East 87 West 91 East 91 West Pipe Manufacturer Western Fiberglass Western Fiberglass Western Fiberglass Western Fiberglass Test Start Time N/A N/A N/A N/A Initial Reading N/A N/A N/A N/A Test End Time N/A N/A N/A N/A Final Reading N/A N/A N/A N/A Change in Reading N/A N/A N/A N/A Pass/Fail Criteria 0 0 0 0 Tightness Test Results ❑ Pass 0 Fail ❑ Pass 0 Fail ❑ Pass 0 Fail ❑ Pass 0 Fail Pipe Run ID Diesel East Diesel West Vapor return Pipe Manufacturer Western Fiberglass Western Fiberglass Ameron Test Start Time N/A N/A 11:00 am Initial Reading N/A N/A 5 psi Test End Time N/A N/A 12:00 pm Final Reading N/A N/A 0 psi Change in Reading N/A N/A 5 Pass/Fail Criteria 0 0 0 Tightness Test Results ❑ Pass 0 Fail I ❑ Pass 0 Fail ❑ Pass 0 Fail ❑ Pass ❑ Fail Additional copies of this page may be attached. All tests marked "Fail"and any repairs made before or during the tightness test must be described in the COMMENTS section. Page 2 of 5