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Recommended Practices for the Testing and Verification of Spill, Overfill, Leak Detection and Secondary Containment Equipment at UST Facilities <br />Facility Name: <br />CONTAINMENT SUMP INTEGRITY TESTING <br />HYDROSTATIC OD <br />Owner: <br />Address: <br />Address: <br />City, State, Zip Code: <br />City, State, Zip Code: <br />Facility I.D. #: <br />Phone #: <br />Testing Company. <br />Phone #: <br />Date: <br />This procedure is to test the leak integrity of containment sumps. See PEI/RP1200 Section 6.5 for the test method. <br />Containment Sump ID <br />Containment Sump <br />Material <br />Liquid and debris <br />removed from sump?* <br />El Yes El No <br />El Yes El No <br />❑ Yes El No <br />❑ Yes ❑ No <br />El Yes El No <br />El Yes El No <br />Visual Inspection (No <br />cracks, loose parts <br />or separation of the <br />containment sump.) <br />❑ pass [--]Fail <br />❑ Pass ❑ Fail <br />❑ Pass [--]Fail <br />❑ Pass ❑ Fail <br />[]Pass ❑ Fail <br />❑ Pass ❑ Fail <br />Containment Sump <br />Depth <br />Height From Bottom to <br />Top of Highest <br />Penetration <br />Starting Water Level <br />Test Start Time <br />Ending Water Level <br />Test End Time <br />Test Period (Minimum <br />test time: 1 hour) <br />Water Level Change <br />Pass/fail criteria: Must pass visual inspection. Water level drop of less than 1/8 inch. <br />Test Results <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />Comments: <br />*All liquids and debris must be disposed of properly. <br />Tester's Name (print) <br />Tester's Signature <br />pei.org 0 <br />