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SWRCB, January 2002 <br />Test Method Developed By: <br />Test Method Used: <br />• <br />4. TANK ANNUL <br />C Tank Manufacturer <br />0 Other (Specify) <br />C Pressure <br />C Other (SDecifv) <br />0 <br />Page _ of <br />Standard C Professional Engineer <br />C Hydrostatic <br />nyu,pu,nnr usea <br />Equipment Resolution <br />e�.m r <br />Tank # <br />Tank # <br />Tank # <br />Tank # <br />Is Tank Exempt From Testing?' <br />C Yes �o <br />C Yes C No. <br />C Yes C No <br />Tank Capacity: <br />C Yes C No <br />Tank Material: <br />(Y <br />Tank Manufacturer: <br />CJN <br />Product Stored: <br />- <br />rvau time between applying <br />Pressure/vacuum/water and <br />startin test: <br />�, •�Y <br />I <br />Test Start Time: <br />O <br />O <br />Initial Reading (Rt): <br />iii <br />! /i <br />y, <br />Test End Time: <br />% O O O <br />T} Q <br />dJD <br />Final Reading (RF): <br />61 <br />Te <br />T ,st Duration: <br />A <br />Change in Reading (RF --Rt): <br />�% <br />Pass/Fa l Threshold or Criteria: <br />Test Result: - <br />ass C Fail 5 <br />ass D Fa;.-- <br />5-PTS's- 0 Fail <br />Was sensor removed for testing? <br />- es C No CNA <br />F*V'k- C No CNA <br />❑ No ❑ NA <br />❑Yes ❑ No CNA <br />Was sensor properly replaced and <br />es C No G NA <br />L� I C <br />verified functional after testing? <br />es No C NA <br />Ije�C No ❑ NA <br />C Yes ❑ No CNA <br />COMMents - (include information on repairs made prior to testing, and recommended ollow up for failed tests) <br />Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary <br />containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic <br />