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Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> 6. TANK SECONDARY CONTAINMENT TEST I <br /> Test Method Developed by ® Manufacturer ® Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ® Vacuum ❑ Hydrostatic <br /> Test Equipment Used: 0-30inHg. 4" Vacuum Gauges w/ 0.05 graduations <br /> ❑ Check this box if Appendix 8.1 continuation page is attached. <br /> Tank ID T-1 87-N T-2 87-S T-3 91 T-4 Diesel <br /> Tank Manufacturer Xerxes 12k Xerxes 10k Xerxes 1Ok Xerxes 10k <br /> Test Start Time 1:45pm 1:45pm 1:45pm 3:12pm <br /> Initial Reading -1Ohg -10hg -10hg -10hg <br /> Test End Time 2:45pm 2:45pm 2:45pm 4:12pm <br /> Final Reading -10hg -1Ohg -10hg -10hg <br /> Change in Reading 0.00 0.00 0.00 0.00 <br /> Pass/Fail Criteria No Loss No Loss No Loss No Loss <br /> Tightness Test Results ® Pass ❑ Fail I ® Pass ❑ Fail I ® Pass ❑ Fail ® Pass ❑ Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ® Manufacturer ® Industry Standard ❑ Professional Engineer <br /> Test Type ® Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: 0-15psi 4" Pressure Gauges w/ 0.05 graduations <br /> ❑ Check this box if Appendix 8.2 continuation page is attached. <br /> Pipe Run ID T-1 87 Product T-2 87 Product T-3 91 Product T-4 DSL Product <br /> Pipe Manufacturer A.O. Smith A.O. Smith A.O. Smith A.O. Smith <br /> Test Start Time 2:00pm 3:22pm 2:00pm 2:38pm <br /> Initial Reading 5.0psi 5.Opsi 5.Opsi 5.Opsi <br /> Test End Time 3:00pm 4:22pm 3:00pm 3:38pm <br /> Final Reading 5.Opsi 5.Opsi 5.0psi 5.Opsi <br /> Change in Reading O.Opsi O.Opsi O.Opsi O.Opsi <br /> Pass/Fail Criteria No Loss No Loss No Loss No Loss <br /> Tightness Test Results ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail <br /> Continuity Test Results ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail <br /> Pipe Run ID <br /> Pipe Manufacturer <br /> Test Start Time <br /> Initial Reading <br /> Test End Time <br /> Final Reading <br /> Change in Reading <br /> Pass/Fail Criteria No Loss No Loss No Loss No Loss <br /> Tightness Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> Continuity Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> Describe in Section 9 all tests marked "Fail'and any repairs made during the test. Page 2 of 4 <br />