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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 0 Pressure M Vacuum 0 Hydrostatic <br /> Tank ID T1 91 T2 87 T3 Diesel <br /> Spill Container Manufacturer: OPw OPw OPw <br /> Method of Cathodic Protection © Nonmetallic ® Nonmetallic ® Nonmetallic ® Nonmetallic <br /> 0 Other 0 Other E Other © Other <br /> Is the spill container minimum ❑ Yes El Yes 0 Yes ® Yes <br /> capacity five gallons excluding ❑ No* ❑ No* ❑ No* ❑ No* <br /> riser volume? <br /> Method to keep spill container ❑ Drain 0 Drain 0 Drain ❑ Drain <br /> empty ❑ Pump Q Pump © Pump ❑ Pump <br /> ❑ Other 0 Other ❑ Other 0 Other <br /> Spill Container Test Results 0 Pass 0 Pass 0 Pass ❑ Pass <br /> ❑ Fail I ❑ Fail I ❑ Fail I ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> Method of Cathodic Protection 0 Nonmetallic ❑ Nonmetallic ® Nonmetallic 0 Nonmetallic <br /> 0 Other ❑ Other © Other ❑ Other <br /> Is the spill container minimum 0 Yes ❑ Yes 0 Yes 0 Yes <br /> capacity five gallons excluding © No* ® No* 0 No* ❑ No* <br /> riser volume? <br /> Method to keep spill container ® Drain ® Drain ® Drain ❑ Drain <br /> empty © Pump ® Pump ® Pump ® Pump <br /> ❑ Other ❑ Other ® Other © Other <br /> Spill Container Test Results ❑ Pass ® Pass ❑ Pass ❑ Pass <br /> ❑ Fail © Fail © Fail ❑ Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other," "No,"or "Fail"and each proposed remedy. <br /> * Mark here if: <br /> r] Spill containers do not have a minimum capacity of five gallons and require replacement. <br /> Additional copies of this page may be attached. <br /> Page 2 of 2 <br />