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Underground Storage Tank <br />Spill Container Testing Report Form <br />6. SPILL CONTAINER DETAILS <br />Test Method Developed by E Manufacturer Q Industry Standard C Professional Engineer <br />Test Type 0 Pressure C Vacuum C Hydrostatic <br />Tank ID <br />87 <br />89 <br />91 <br />Spill Container Manufacturer: <br />OPW <br />OPW <br />OPW <br />Method of Cathodic Protection <br />Nonmetallic <br />C <br />Nonmetallic <br />C <br />Nonmetallic <br />C <br />Nonmetallic <br />C <br />Other <br />© <br />Other <br />C <br />Other <br />© <br />Other <br />Is the spill container minimum <br />C <br />Yes <br />0 <br />Yes <br />0 <br />Yes <br />® <br />Yes <br />capacity five gallons excluding <br />C <br />No* <br />C <br />No* <br />C <br />No* <br />C <br />No* <br />riser volume? <br />Method to keep spill container <br />C <br />Drain <br />C <br />Drain <br />C <br />Drain <br />C <br />Drain <br />empty <br />C <br />Pump <br />FEI <br />Pump <br />C <br />Pump <br />C <br />Pump <br />© <br />Other <br />0 <br />Other <br />0 <br />Other <br />0 <br />Other <br />Spill Container Test Results <br />C <br />Pass <br />El <br />Pass <br />0 <br />Pass <br />D <br />Pass <br />Fail <br />0 <br />Fail <br />Ej <br />Fail <br />0 <br />Fail <br />Tank ID <br />Spill Container Manufacturer: <br />Method of Cathodic Protection <br />C <br />Nonmetallic <br />C <br />Nonmetallic <br />C <br />Nonmetallic <br />0 <br />Nonmetallic <br />0 <br />Other <br />® <br />Other <br />® <br />Other <br />0 <br />Other <br />Is the spill container minimum <br />0 <br />Yes <br />C <br />Yes <br />© <br />Yes <br />© <br />Yes <br />capacity five gallons excluding <br />C <br />No* <br />C <br />No* <br />C <br />No* <br />0 <br />No* <br />riser volume? <br />Method to keep spill container <br />® <br />Drain <br />C <br />Drain <br />C <br />Drain <br />© <br />Drain <br />0 <br />Pump <br />® <br />Pump <br />® <br />Pump <br />C <br />Pump <br />empty <br />® <br />Other <br />C <br />Other <br />C <br />Other <br />C <br />Other <br />Spill Container Test Results <br />C <br />Pass <br />® <br />Pass <br />C <br />Pass <br />C <br />Pass <br />I El <br />Fail <br />C <br />Fail <br />C <br />Fail <br />C <br />Fail <br />8. COMMENTS <br />Describe all answers marked "Other," "No,"or "Fail" and each proposed remedy. <br />Replaced 89 fill cap, 89 fill bucket, and 89 fill swivel due to leaks during spill container <br />testing. <br />* Mark here if: <br />FM Spill containers do not have a minimum caaacity of five aallons and reauire replacement. <br />Additional copies of this page may be attached. <br />Page 2 of 2 <br />