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Underground Storage Tank <br /> Spill Containment Testing Report Form <br /> 6. SPILL CONTAINMENT DETAILS <br /> Test Method Developed by ❑ Manufacturer V Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure 0 Vacuum El Hydrostatic <br /> ❑ Check this box if Appendix 5.1 cor}1:inuation page is attached. <br /> Tank ID T1 Supreme T2 Regular 2 T3 Regular 1 <br /> Spill Containment Manufacturer: OPw OPw OPw <br /> Method of Cathodic Protection 0 Nonmetallic 0 Nonmetallic ✓❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑Other ❑ Other <br /> Is the spill containment 0 Yes 0 Yes 0 Yes ❑ Yes <br /> minimum capacity five gallons <br /> excluding riser volume? [-1 No* El No* El No* El No* <br /> Method to keep spial 0 Drain 0 Drain 2 Drain ❑ Drain <br /> containment empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> ❑ Other ❑ Other ❑Other ❑ Other <br /> Spill Containment Test Results Z Pass ❑✓ Pass ❑✓ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Containment Manufacturer: <br /> Method of Cathodic Protection ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑Other ❑ Other <br /> Is the spill containment ❑ yes ❑ Yes ❑Yes ❑ Yes <br /> minimum capacity five gallons ❑ No* ❑ No* ❑ No* ❑ No* <br /> excluding riser volume? <br /> Method to keep spill ❑ Drain CJ Drain ❑ Drain ❑ Drain <br /> containment empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> ❑Other ❑ Other ❑Other ❑ Other <br /> Spill Containment Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 7. COMMENTS <br /> * ❑ Check this box if any spill containment has less than 5 gallons capacity and requires <br /> replacement. <br /> Describe all answers marked `Other." `"No."'or'`Fail" and each proposed remedy in Section 7. <br /> Page 2 of 2 <br />