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S WRCB January,2002 • • Page of_ 7. UNDER-DISPENSER CONTAINMENT C)TESTING Test Method Developed By: ❑UDC Manufacturer ❑ Industry Standard ❑ Professional Engineer ❑Other(Specify) Test Method Used: ❑Pressure ❑ Vacuum ❑ Hydrostatic ❑Other(Specify) Test Equipment Used: Equipment Resolution: UDC# UDC# UDC# UDC# UDC Manufacturer. UDC Material: UDC Depth: Height from UDC Bottom to Top of Highest Piping Penetration: Height from UDC Bottom to Lowest Electrical Penetration: Condition of UDC prior to testing: Portion of UDC Tested Does turbine shut down when UDC sensor detects liquid(both ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA product and water)?* Turbine shutdown response time Is system programmed for fail- safe shutdown?. ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA Was fail-safe verified to be ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No [INA operational?* Wait time between applying pressure/vacuum/water and starting test Test Start Time: Initial Reading(Ri): Test End Time: Final Reading(RF): Test Duration: Change in Reading(RF-R): Pass/Fail Threshold or Criteria: Test Result: L)Pass ❑Fail ❑ ❑Pass ❑Fail r ❑Pass ❑Fail ❑ ❑Pass ❑Pail d Was sensor removed for testing? ❑Yes ❑ No ❑NA ❑Yes _❑ No ❑ N_A_ ❑_Yes ❑ No ❑NA ❑Yes ❑No ❑NA Was sensor properly replaced and verified functional after testing? ❑Yes ❑ No ❑NA ❑Yes ❑ No ❑ NA ❑Yes ❑ No ❑NA ❑Yes ❑No ❑ NA Comments—(include information on repairs made prior to testing,and recommended fallow-up for failed tests) If the entire depth of the UDC is not tested,specify how much was tested If the answer to any of the questions indicated with an asterisk (')is"NO"or"NA",the entire UDC must be tested. (See SWRCB LG-160)