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r , S WRCB, January 2002 <br />8. <br />Page of <br />FILL RISER CONTAINMENT SUMP TESTING <br />Facility is Not Eguipped With Fill Riser Containment Sums ❑ <br />Fill Riser Containment Sm are Present, but were Not Tested 0- <br />Test Method Developed By: <br />7 <br />❑ Sump Manufacturer ❑ Industry Standard ❑ Professional Engineer <br />❑ Other (Spec) <br />Test Method Used: <br />❑ Pressure ❑ Vacuum <br />❑ Other (Spec) <br />❑ Hydrostatic � <br />Test Equip m t Used: <br />Sump Diameter: <br />Fill Sump # Fill Sump # <br />Equipment Resolution: <br />Fill Sum # / Fill Sum # <br />Sump Depth: <br />/ <br />Height from Tank Top to To of <br />Highest Piping Penetration: <br />Height from Tank Top to Lowest <br />Electrical Penetration: <br />Condition of sump prior to <br />testing: <br />Portion of Sump Tested <br />Sump Material: <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br /></ <br />Test Start Time: <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 Criteria: <br />Test Result: <br />O Pass ❑ Fail ❑ Pass ❑ Fail <br />❑ Pass Fail ❑ Pass ❑ Fair <br />Is there a sensor in the sum <br />❑ Yes ❑ No ❑ Yes ❑ No <br />❑ Yes ❑ ❑ Yes ❑ No <br />Does the sensor alarm en <br />either product or wat is <br />detected? <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA ❑ No ❑ NA <br />Was sensor re ved for testing? <br />❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA <br />❑ Yes C1 No ❑ NA ❑ Yes o ❑ NA <br />Was seior properly replaced and <br />veri5Ld functional after testing? <br />❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA ❑ Yes ❑ No NA <br />E <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />