Laserfiche WebLink
Underground Storage Tank <br /> Spill Container Testing Report Form <br /> S. SPILL CONTAINER DETAILS <br /> Test Method Developed by 0 Manufacturer ❑ Industry Standard El Professional Engineer <br /> Test Type U Pressure ❑ Vacuum 0 Hydrostatic <br /> Tank ID Regular Premium Diesel <br /> Sol I Container Manufacturer: O W OPW OP <br /> Method of Cathodic Protection ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ® Other 0 Other 2 Other Q Other <br /> Is the spill container minimum M Yes 0 Yes E Yes ❑ Yes <br /> capacity fve gallons excluding ❑ No* Q No} ❑ No" ❑ No's <br /> riser volume"? <br /> 0 Drain 23 Drain ❑ Drain ❑ Drain <br /> Method to }seep spill container ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results X Pass 2 Vass R Pass El Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> pi[I Container Manufacturer, <br /> Method of Cathodic Protection ❑ Nonmetaalic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other d Other <br /> Is the spill container minimum ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* C Nom ❑ No- 0 No- <br /> riser volume? __ <br /> ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> Method to keep spill container rl Pump D Pump ❑ Pump ❑ Purnp <br /> empty ❑ Other _ ❑ Other ❑ Other ❑ Other <br /> Spill CoMai ner Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8. COMM ENT - <br /> Describe all answers marked "Other," uNo," or"Fail"and each proposed remedy. <br /> I <br /> * Mark here if; <br /> ❑ 5p.ill containers do not have a minimum capacity of fve gallons and require replacerrtient. <br /> Aciditional copies of this page may be attached- <br /> Page 2 of <br />