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Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> 6. TANK SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer ❑ Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacu u m ❑ Hydrostatic <br /> Test Equipment Used: <br /> ❑ Check this box if Appendix 8.1 continuation page is attached. <br /> Tank ID 1-Super 91 2-Regular87 3-Diesel <br /> Tank Manufacturer O C Tank O C Tank O C Tank <br /> Test Start Time *NA Exempt *NA Exempt *NA Exempt <br /> Initial Reading <br /> Test End Time <br /> Final Reading <br /> Change in Reading <br /> Pass/Fail Criteria <br /> Tightness Test Results <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by X Manufacturer ❑ Industry Standard ❑ Professional Engineer <br /> Test Type x Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: Pressure Gauges in Psi/Nitrogen <br /> ❑ Check this box if Appendix 8.2 continuation page is attached. <br /> Pipe Run ID 1-Su per 91 2-Regular 87 3-Diesel <br /> Pipe Manufacturer Smith Smith Smith <br /> Test Start Time 1:25 1 :20 1:30 <br /> Initial Reading 3 Psi 3 Psi 3 Psi <br /> Test End Time 2:25 2:20 2:30 <br /> Final Reading 3 Psi 3 Psi 3 Psi <br /> Change in Reading 0 Psi 0 Psi 0 Psi <br /> Pass/Fail Criteria No Loss No Loss No Loss <br /> Tightness Test Results P a s s P a s s P a s s <br /> Continuity Test Results P a s s P a s s P a s s <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 <br /> Tightness Test Results <br /> Continuity Test Results <br /> Describe in Section 9 all tests marked "Fail"and any repairs made during the test. Page 2 of 4 <br />