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0 0 <br />SWRCB, January 2002 FINAL DRAFT <br />4 TANK ANNCiLAR <br />Page 2 of 7 <br />ar, li\V <br />Test Method Developed By: ❑ Tank Manufacturer Industry Standard ❑ Professional Engineer <br />❑ Other (Spec fi) <br />I cnt ivtctoou iJseu.❑Pressure l__I Vacuum H::d ostatic <br />❑ Other (Spec) <br />Test Equipment Used: Equipment ,; ;soluttvn: <br />— Tank # Tank #1j Tank # Tank # —� <br />Is Tank Exempt From Testing?l <br />❑Yes No <br />❑Yes Na ❑Yes ❑No ❑Yes ❑No <br />Tank Capacity: <br />Tank Material: <br />Tank Manufacturer: <br />Product Stored: <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />Test Start Time: <br />Initial Reading (Rt): <br />Test End Time: <br />d G <br />63 e' <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (RF -Rt): <br />Pass/Fail Threshold or Criteria: <br />Test Result <br />[Pass ❑Fail <br />0 -Pass ❑Fail ❑Pass ❑Fail ❑Pass ❑Fail <br />Was sensor removed for testing? <br />❑Tes ❑No ❑NA <br />BYes ❑No [INA ❑Yes ❑No ❑NA ❑yes ❑No ❑NA <br />Was sensor property replaced and <br />verified functional after testing? <br />es ❑No ❑NA <br />1:1 -Yes ❑No ❑NA ❑Yes ❑No `INA ❑ ❑Yes No ❑NA <br />Comments — Occlude information on repairs made_ prior to testing, and rermm�ren led fol/ow-t!r ;_ •failed tes!s,t <br />Secondary containment systems Nchere the continuous monitoring automatically monitors both the primary and secondary <br />CNIW iit,:nent, such as systems that arc h'Wrostaticai'y monitored or under constant vacuum, are e\entpt from periodic containment <br />Ming. (Cahf)rnia Code of Regulations, Title 23, Section 2637(a)(6)) <br />