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SWRCB,January 2002 Page_of <br /> S. FILL RISER CONTAINMENT SUMP TESTING <br /> Facility is Not Equipped With Fill Riser Containment Sumps ❑ <br /> Fill Riser Containment Sumps are Present,but were Not Tested ❑ <br /> Test Method Developed By: ❑Sump Manufacturer ❑Industry Standard 0 Professional Engineer <br /> 0 Other(Specify) <br /> Test Method Used: ❑Pressure ❑Vacuum ❑Hydrostatic <br /> 0 Other(Specify) <br /> Test Equipment Used: Fquipmcnt Resolution: <br /> Fill u-m-P# Fill Sump# Fillamp# Fill <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 /> testing: <br /> Portion of Sump Tested <br /> Sump Material: <br /> Wait time between applying <br /> pressure/vacuum/water and <br /> starting test: <br /> Test Start Time: <br /> Initial Reading(1(j): <br /> Test End Time: <br /> Final Reading(k): <br /> Test Duration: <br /> Change in P eading(RF-RO: <br /> Pass/Fail Threshold or Criteria; <br /> Test Result: 0 Pass 0 Fail ❑ Pass 0 Fail ❑ Pass DFaH ❑ Pass ❑Fail <br /> Is there a sensor in the sump? ❑Yes DNo 0 Yes ONo ❑Yes ONo ❑Yes ONo <br /> Does the sensor alarm when <br /> either product or water is ❑Yes DNo ❑NA ❑Yes ❑No DNA 0 Yes DNo 0 NA ❑Yes ❑No DNA <br /> detected? <br /> Was sensor removed for testing? I ❑Yes DNo DNA ❑Yes DNo ❑NA ❑Yes DNo ❑NA ❑Yes DNo DNA <br /> Was sensor properly replaced and ❑Yes DNo ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes DNo ❑NA <br /> verified functional after testing? I I I <br /> Comments—(include information on repairs made prior to testing, and recommended follow-up for failed tests) <br /> Recommended. BUT NOT REOUIRED <br />