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Page 5 of 8 0 ro 7. UNDER-DISPENSER CONTAINMENT(UDC)TESTING Test Method Developed By: ❑UDC Manufacturer 0 Industry Standard ❑ Professional Engineer ❑ Other(Specify) Test Method Used: ❑ Pressure ❑Vacuum El Hydrostatic ❑ Other(Specify) Test Equipment Used: 1 hour LAKE Test: Equipment Resolution: UDC # 1-2 UDC # 3-4 UDC # 5-6 UDC # 6S-7S UDC Manufacturer: Unknown Unknown Unknown Unknown UDC Material: Fiberglass Fiberglass Fiberglass Fiberglass UDC Depth: 42" 42" 42" 42" Height from UDC Bottom to Top of 9 '/2" 9 1/2" 9 '/z" 9 Y2 Highest Piping Penetration: Height from UDC Bottom to Lowest 12" 12" 12" 12" Electrical Penetration: Condition of UDC prior to testing: D D Dr D Portion of UDC Tested' 2"Above Product 2"Above Product 2"Above Product 2"Above Product Does turbine shut down when UDC sensor detects liquid(both product ® Yes ❑ No 0 NA ❑ Yes El No 0 NA 0 Yes L3 No NA E3 Yes ❑ No ® NA and water)?* Turbine shutdown response time Is system programmed for fail-safe ❑ Yes 13 No ❑x NA ❑ Yes ❑ No EI NA ❑Yes L1 No I]NA ❑ Yes ❑ No 191 NA shutdown?' Was fail-safe verified to be ❑ Yes ❑ No I@ NA ❑Yes ❑ No Z NA ❑ Yes ❑ No 0 NA ❑ Yes ❑ No 19 NA operational?' Wait time between applying 5 minutes 5 minutes 5 minutes 5 minutes pressurefvacuumlwater and starting test Test Start Time: 2:50 PM 2:50 PM 2:50 PM 2:50 PM Initial Reading(Ri): 13" 13 3/8" 13 10/16" 13 1/4" Test End Time: 3:50 PM 3:50 PM 3:50 PM 3:50 PM Final Reading(RF): 13" 13 3/8" 13 10/16" 13 '/4" Test Duration: 1 hour 1 hour 1 hour 1 hour Change in Reading(RF-Ri): 0 0 0 0 Pass/Fail Threshold or Criteria: 0 0 0 0 Test Result: [M Pass ❑ Fail 0 Pass ❑ Fail [H] Pass ❑ Fail ® Pass ❑ Fail Was sensor removed far testin ? 0 Yes ❑ No ❑ NA 21 Yes ❑ No ❑ NA D Yes ❑ No ❑ NA ®Yes C] No ❑ NA Was sensor properly replaced after IM Yes ❑ No ❑ NA 0 Yes ❑ No ❑ NA 0 Yes ❑ No ❑ NA 19 Yes ❑ No ❑ NA testing? Comments— include information on repairs made prior to testing, and recommended follow-up for farted tests Turbine Shut Down done during Annual Monitor Certification. ' If the entire depth of the UDC is not tested,specify how much was tested. if the answer to py of the questions indicated with an asterisk(*)is"NO"or"NA",the entire UDC must be tested. (See SWRC13 LG-160)