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Page 6 of 7 <br /> S. FILL RISER CONTA0*1ENC SUMP TESTING <br /> Facility is Not Equipped With Fill Riser Containment Sums 0 <br /> Fill.Riser Containment Sumps are Present,but were Not Tested 0 <br /> Test Method Developed By: 0 Sump Manufacturer 0 Industry Standard O Professional Engineer <br /> 0 Other(Specify) <br /> Test Method Used: Cl Pressure 0 Vacuum 0 Hydrostatic <br /> D Other(Specify) <br /> Test Equipment Used: Equipment Resolution: <br /> Fill Smnp# Fill sump# Fill SUMP 3t Fill Sum # <br /> Sump Diameter: <br /> Sump Depth: <br /> Height from Tank Top to Top of <br /> Highest Piping Penetration: <br /> Height from Tank Top to Lowest <br /> Electrical Penetration: <br /> Condition of sump prior to <br /> testin <br /> Portion of SUPIR Tested <br /> Sump Material: <br /> Wait time between applying <br /> pressure/vacuum/water and <br /> startingtest: <br /> Test Start Time: <br /> Initial ReadinT): <br /> Test End Time: <br /> Final Reading <br /> Test Duration: <br /> Chan a in Readin �,- <br /> Pass�Fail Threshold or Criteria: <br /> Test Result: 0 Pass D Fail 0 Pass 0 FOR O Pass 0 FOR 0 Pass 0 Fail <br /> Is there a sensor in the su ? 0 Yes 0 No 0 Yes 0 No 0 Yes 0 No D Yes 0 No <br /> Does the sensor alarm when <br /> either product or water is O Yes ONO [INA 0 Yes ONO [INA D Yes ONO CI NA O Yes ONO DNA <br /> detected? <br /> Was sensor removed for testing? []Yes 0 No O NA 0 Yes D No DNA O Yea ONO CI NA I C Ye$ ONO DNA <br /> Was sensor properly replaced and ❑Yes ONO DNA D Yes D No DNA I oyes 0 No O NA I D Yes ONO DNA <br /> verified functional after testing? <br /> Comments—(include information ort repaint madegrior to resting and recommadedfollow-rrpforfailed tests) <br /> C4mvonets passed required vember 3.0-"- 005 <br />