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Page Z of_ <br /> 4. TANK ANNULAR TESTING _ <br /> Test Method Developed By: D Tank Manufacturer ® Industry Standard D Professional Engineer <br /> D Other(Specify) <br /> Test Method Used: D Pressure ® Vacuum D Hydrostatic <br /> D Other(Specify) <br /> Test Equipment Used: DIAL GAUGE Equipment Resolution:0 to 15"Hg Vacuum <br /> Tank# Tf 7 Tank# L Tank# Tank# <br /> Is Tank Exempt From Testing?' Yes D No Yes D No XYes D No .0 Yes D No <br /> Tank Capacity: GALLONS GALLONS GALLONS GALLONS <br /> Tank Material: <br /> Tank Manufacturer: <br /> Product Stored: <br /> Wait time between applying <br /> pressure/vacuum/water and 15 Minutes 15 Minutes 15 Minutes 15 Minutes <br /> starting test: <br /> Test Start Time: <br /> Initial Reading(Rj): " HG "HG " HG "HG <br /> Test End Time: <br /> Final Reading(RF): "HG " HG "HG " HG <br /> Test Duration: 1 Hour 1 Hour 1 Hour 1 Hour <br /> Change in Reading(RF-RO: "HG "HG "HG " HG <br /> Pass/Fail Threshold or Criteria: Zero Zero Zero Zero <br /> iiEIt:- - _ aSl © i'ass _ <br /> A <br /> ." _ .. - <br /> Was sensor removed for testing? D Yes 41 No O NA D Yes_ANo D NA D Yes,ANo O NA O Yes D No D NA <br /> Was sensor properly replaced and D Yes D No J?NA 11 es D No XNA D Yes D No ANA D Yes D No DNA <br /> verified functional after testing? <br /> COIn mats—(include information on repairs made prior to testing,and recommended follow-up for failed tests) <br /> V t' <br /> ve <br /> Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary <br /> containment,such as systems that are hydrostatically monitored or under constant vacuum,are exempt from periodic containment <br /> testing. I California Code of Regulations,Title 23,Section 2637(a)(6)) <br />