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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 6 , SPILL CONTAINER DETAILS <br /> Test Method Developed by 8 Manufacturer 8 Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum B Hydrostatic <br /> Tank ID 87 OCTANE 87 OCTANE - B 91 OCTANE <br /> Spill Container Manufacturer: O P W O P W O P W <br /> Method of Cathodic Protection 8 Nonmetallic 8 Nonmetallic 8 Nonmetallic EJ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum 8 Yes 8 Yes B Yes ❑ Yes <br /> capacity five gallons excluding ❑ No * ❑ No * ❑ No * ❑ No * <br /> riser volume ? <br /> 8 Drain 8 Drain 8 Drain ❑ Drain <br /> Method to keep spill container ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results 8 Pass 8 Pass 8 Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> Method of Cathodic Protection ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No * ❑ No * ❑ No * ❑ No * <br /> riser volume ? <br /> ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> Method to keep spill container ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8 . COMMENTS <br /> Describe all answers marked "Other, " "No, " or "Fail" and each proposed remedy. <br /> * Mark here if: <br /> ❑ Spill containers do not have a minimum capacity of five gallons and require replacement . <br /> Additional copies of this page may be attached. <br /> Page 2 of 2 <br />