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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 ❑ Vacuum ❑ Hydrostatic Test Equipment Used:0-30 inHG Gauges Tank ID 87-1 87-2 91 Tank Manufacturer Xerxes Xerxes Xerxes Tank Capacity 10,000 10,000 8,000 Test Start Time 11:10 am 11:10 am 11:10 am Initial Reading 10 hg 10 hg 10 hg Test End Time 12:10 pm 12:10 pm 12:10 pm Final Reading 10 hg 10 hg 10 hg Change in Reading 0 0 0 Pass/Fail Criteria 0 0 0 Tightness Test Results 0 Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail 7. PIPE SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer ❑ Industry Standard ❑ Professional Engineer Test Type ❑ Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used:0-10 PSI Gauges Pipe Run ID 87-1 product 87-2 product 91 product Pipe Manufacturer Smith Smith Smith Test Start Time N/A 10:00 am 10:00 am Initial Reading N/A 5 psi 5 psi Test End Time N/A 11:00 am 11:00 am Final Reading N/A 5 psi 5 psi Change in Reading N/A 0 0 Pass/Fail Criteria 0 0 0 Tightness Test Results ❑ Pass 0 Fail 0 Pass ❑ Fail 0 Pass ❑ Fail ❑ Pass ❑ Fail Pipe Run ID Pipe Manufacturer Test Start Time Initial Reading Test End Time Final Reading Change in Reading Pass/Fail Criteria Tightness Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ 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 2of5