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SWRCB, January 200-z <br />FALL RISFR CONI tWW,'4"T CTT1b1P TV..-,-nNe_ <br />Page of <br />Facility is Not Equipped With Fill Riser Containment Sumps <br />G <br />Fill Riser Contaiffitetn Sumps are Present but were tint Tested 0 <br />TestMethod Developed By <br />❑ Sump Manufacture; <br />❑ Other (Specify) <br />industry Standard professionai Fxgineer <br />j Test Method Used: <br />C Pressure <br />C' Other (Spec) <br />Vacuum <br />! Hydrostatic <br />Test Egwpnwm Used: <br />Sump Diameter- <br />iameterSum <br />FM Sump # / <br />FAIL Smmnp # <br />Equipment Resohrtion: <br />FiR Sump # Fffi Same # <br />Sum <br />Height from Tank Top to Toa of <br />ffighest Piping Penetration <br />Height from Tank Top to Lowest <br />Electrtcai Penetration. - <br />i <br />Condition of sump prior to <br />testing: <br />n <br /><✓ r <br />� �E/ <br />n <br />Z <br />Portion of Sump Tested <br />Sump Material: <br />G <br />Wait time between applying <br />pressureivacuumiwater and <br />starting tit: <br />% I✓1 7 <br />/47 .47 <br />Test Start Time: <br />z <br />pO <br />3p <br />Initial Reading QZ4): <br />�= — <br />Test End Time: <br />% <br />Test Duration <br />O s� "✓� <br />0 n <br />l/ �'1 'n <br />: J��/ /l <br />Change in (R- :- <br />j <br />Pass/Fafl Threshold or Criteria: <br />'r , - ,,� <br />� <br />d ;,7L -,r <br />M <br />Is there a sensor in the sump? <br />es ❑ No <br />es Q No <br />C i'es ^ No <br />P— es ❑ No <br />Does the sensor alarm when <br />either product or water is <br />detected? <br />a Yes El No _ <br />0 Yes ❑ No <br />❑ Yes ❑ No <br />Q Yes :!No <br />Was sensor removed for testing? <br />es Q No 0 NA <br />sales V No ONA <br />es ONo F', NA <br />es Q -No DNA <br />Was sensor properly replaced and <br />i verified nmctionai'after mzttng <br />No Q NA <br />21es ❑ No J NA <br />i <br />' ,' es -- No NA <br />es ❑ No a NA <br />j <br />COmmemts - (include informanan on repairs made prior to mstrn , and recommended follow-up for failed tests) <br />