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Page 2 of 8 <br /> 4. TANK ANNULAR TESTING <br /> Test Method Developed By: ❑Tank Manufacturer ff] Industry Standard ❑ Professional Engineer <br /> Other(Specify) <br /> Test Method Used: ❑ Pressure El Vacuum ❑ Hydrostatic <br /> ❑Other(Specify) <br /> Test Equipment Used: Vacuum Gauge Equipment Resolution: 0-30 Hg <br /> Tank # 1 Tank # Tank # Tank # <br /> Is Tank Exempt From Testing?' ❑ Yes 0 No ❑ Yes ❑ No L3 Yes ❑ No L3 Yes Ll No <br /> Tank Capacity: 20,000 gallons <br /> Tank Material: Steel <br /> Tank Manufacturer: Unknown <br /> Product Stored: Reg/Prem <br /> Wait time between applying <br /> pressurelvacuumlwaterand starting 5 minutes <br /> test: <br /> Test Start Time: 12:00 PM <br /> Initial Reading(Ri): -10 Hg <br /> Test End Time: 1:00 PM <br /> Final Reading(RF): -10 Hg <br /> Test Duration: 1 hour <br /> Change in Reading(RF-Ri): 0 <br /> Pass/Fail Threshold or Criteria: 0 <br /> Test Result: T1 Pass ❑ Fail ❑ Pass ❑ Fail Q Pass ❑ Fail Q Pass ❑ Fail <br /> Was sensor removed for testing? ©Yes Q No [INA ❑Yes Q No ❑ NA ❑Yes ❑ No ❑ NA ❑Yes ❑ No ❑ NA <br /> Was sensor properly replaced after 0 Yes ❑ No ❑ NA O Yes ❑ No ❑ NA ❑Yes ❑ No ❑ NA Q Yes ❑ No ❑ NA <br /> testing? <br /> Comments— include information on repairs made prior to testing,and recommended follow-up for failed tests <br /> ' Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment, <br /> such as systems that are hydrostatically monitored or under constant vacuum,are exempt from periodic containment testing. <br /> (California Code of Regulations,Title 23, Section 2637(x)(6)) <br />