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SWRCB, January 2002 <br />ILL CONTAINMENT BOXES <br />Page of <br />y. <br />arILL/OVip-mr <br />Facility is Not Equipped With Spill/Overfill Containment Boxes ❑ <br />Spill/Overfill Containment Boxes are Present, but were Not Tested ❑ <br />Test Method Developed By: <br />❑ Spill Bucket Manufacturer n ustry Standard ❑Professional Engineer <br />❑ Other (Spec) <br />Test Method Used: <br />❑ Pressure ❑ Vacuum ydrostatic <br />❑ Other (Specie) <br />Test Equipment Used: �� <br />�' �' ✓ F� �� P <br />rt5r :'S3r:%:MnWrrta'lte::�RiSSR'¢S. <br />Equipment Resolution: <br />ri7�Sf n. ir r<.. <br />x,14alIS...I'4?4G4'a^�`1 k4:ii.„�.t,5u�'�y;:%. <br />iSri,WLF��:ih'l+inn#�k'1.?L21.1is���?P.1��,7 <br />Spill Box # Spill Box # Spill Box # Spill Box # <br />�� �'- <br />Bucket Diameter:��'- <br />/117 <br />Bucket Depth: <br />7 /7- <br />Waittime between applying <br />-gait—time <br />pressure/vacuum/water and <br />starting test: <br />i 0 975 <br />Test Start Time: - <br />, <br />Initial Reading (Ri): <br />Test End Time: <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (RF-Ri):- <br />Pass/Fail Threshold or.`, <br />` <br />Criteria: <br />Test Result: <br />`� 'r <br />B-P�"ss ❑Fail B�-P� ❑ Fail <br />�^�'a�s" ❑ Fail <br />D:-F�ss” ❑ Fail <br />Commenis — (include information on repaifs made prior to testing, and recommended follow-up for failed tests) <br />Please direct any comments regarding this form to: <br />SWRCB UST Program, Attn: Scott Bacon <br />1001 "I" Street, Box 944212 <br />Sacramento, CA 95814 <br />Phone: (916) 341-5873, Fax: (916) 341-5808 <br />e-mail: bacons@cwp.swrcb.ca.gov <br />