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i Page of. J- 4. TANK ANNULAR TESTING Test Method Developed By: ❑Tank Manufacture—t®Industry Standard ❑Professional Engineer ❑Other(Specify) Test Method Used: 1]Pressure ®Vacuum O Hydrostatic i ❑Other(Specify) Test Equipment Used:...DIAL.GAUGE_._...... .._. Equipment Resolution.:0 to 15"Hg Vacuum Tank# Tank# Tank# Tank# Is Tank Exempt From Testing?' [I Yes ❑No [I Yes ❑No ❑Yes ❑No ❑Yes ❑No Tank Capacity: GALLONS GALLONS GALLONS _ GALLONS Tank Material: Tank Manufacturer: -- Product Stored: _ — ------ Wait time between applying pressure/vacuum/water and 15 Minutes 15 Minutes 15 Minutes 15 Minutes starting test: — — 1_ Test Start Time: — - „HG Initial Reading(RO: ” HG 'HG "HG i Test End Time: Final Reading(RF): "HG "HG HG "HG Test Duration: — 1 Hour 1 Hour 1 Hour, 1 Hour „HG „HG "HG "HG � Change in Reading(RF-12D.: — - Pass/Fail Threshold or Criteria: Zero Zero Zero Zero �f'+rt+'f..?.F �ti�r,i.St�F - w, - ♦- i r 1�. �� a a,y., l YT' 111 't-t r'd.ria•. k, •s iy`�. � � ,- a� �� i� ��Al��.��`'�' �� ,'dllt.t 1 ^.!:-r1{ Was sensor removed for testing? ❑Yes El No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA i [M—Was sensor properly replaced and ❑yes i]No ❑NA L7 Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA verified functional after testin ? i Comments-(include information ort repairs made prior to testing,and recommended follow-up for failed tests) i i i �BP#06080 85 E.Louise Ave Lathrop, Ca 04475 SB989 i r Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment,such as systems that are hydrostatically monitored or under constant vacuum,are exempt from periodic containment testing {CalifomiaCode ofReguladons,Tit1e23,Section 2637(a)(6))