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Underground Storage Tank <br />Spill Container Testing Report Form <br />6. SPILL CONTAINER DETAILS <br />Test M+ thod Developed by ❑ Manufacturer p Industry Standard El <br />Tpgt Tvne <br />rofessionai Engineer <br />r'"] Pressure ❑ Vacuum 0 Hydrostatir, <br />Tank 1D <br />87 <br />91 <br />DSL <br />Spill Container Manufacturer: <br />OPS <br />OPW <br />DPW <br />❑ Nonmetallic <br />L7 Nonmetallic <br />0 <br />Nonmetallic <br />m Nonmetallic <br />Method of Cathodic Protection <br />[M <br />Other <br />mOther <br />❑ <br />Other <br />❑ <br />Other <br />Is the spill container rninimum <br />Yes <br />p <br />Yes <br />® <br />Yes <br />❑ <br />Yes <br />capacity five gallons excluding <br />❑too- <br />❑ <br />o* <br />❑ <br />o* <br />p <br />No* <br />risef volume? <br />© <br />Drain <br />® <br />Drain <br />F1 <br />Drain <br />p <br />Drain <br />Method to keep spill container <br />r <br />Pump <br />❑ <br />Pump <br />[I <br />Pump <br />p <br />Pump <br />empty <br />Other <br />❑ <br />Other <br />❑ <br />Other <br />❑ <br />Other <br />F.1 <br />Pass <br />❑ <br />Pass <br />M <br />Pass <br />❑ <br />Pass <br />Spill Container Test Results <br />E] <br />Fail <br />I E] <br />Fail <br />D <br />Fail <br />❑ <br />Fail <br />Tank ID <br />Spill Container Mar+ufacturer: <br />r Nonmetallic❑ <br />Nonmetallic <br />17 <br />Nonmetallic <br />❑ <br />hlonmetallic <br />Method of Cathodic Protection <br />-] <br />❑ <br />Other <br />Other <br />❑ <br />Other <br />m <br />Other <br />Is the spill container minimum <br />❑ <br />Yes <br />❑ <br />Yes <br />❑ <br />Yes <br />p <br />Yes <br />capacity five gallons excluding <br />� <br />Ne. <br />❑ <br />o* <br />0 <br />No* <br />❑ <br />No* <br />riser volume? <br />❑ <br />Drain <br />El <br />Drain <br />❑ <br />Drain <br />El <br />Drain <br />Method to keep spill container <br />M <br />E)Purtrp <br />r] <br />Pump <br />❑ <br />Pump <br />1:1Purnp <br />empty <br />D <br />Other <br />❑ <br />Other <br />❑ <br />Other <br />Other <br />❑ <br />Pass <br />❑ <br />Pass <br />❑ <br />Pass <br />❑ <br />Pass <br />Spill Container Test Results <br />❑ <br />Fail <br />❑ <br />Fail <br />m <br />Fail <br />M <br />Fail <br />8. COMMENTS <br />Describe all answers marked "Other, " "No " or "Fail" and each prmpesed remedy, <br />Replaced the fill adaptor o -ring on the 87 bucket. Retested and passed. <br />} Mark here if_ <br />❑ Spill containers do not have a minimum ca <br />Additional copies of this gage may be attached, <br />of five <br />Ilons and require replacement_ <br />Page 2of2 <br />