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SWRCB, January 2002 • • Page _ of <br />S. SPTT,T./nVFRFTT.T. (`nW TAYW?uirm-r nnvve <br />Facility is Not Equipped With Spill/Overfill Containment Boxesv❑ <br />Spill/Overfill Containment Boxes are Present, but were Not Tested ❑ <br />Test Method Developed By: , Spill Bucket Manufacturer ❑ Industry Standard Professional Engineer <br />❑ Other (Specif}) <br />_ <br />Test Method Used: -- Pressure ❑ Vacuum ❑ Hydrostatic <br />❑ Other (Speci6) <br />Test Equipment Used Equipment Resolution. —� <br />_._.ur.'3Xi:.�-.nt � ' . <br />'r"a'�.�_c <br />Spill Box # Spill Box #; Spill Box # Spill Box # <br />Bucket Diameter: <br />Bucket Depth: <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />Test Start Time: <br />-- <br />Initial Reading (R,): <br />Test End Time: <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (RF -R,): <br />Pass/Fail Threshold or <br />Criteria: <br />Test Result: <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass ` ❑ Fail <br />❑Pass❑Fail <br />Comments — (include information on repairs made prior to testing and recommended follow-up for failed tests) <br />