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S WRCB, January 2002 <br />4_ TANK ANNITI.AR TlP4QTIivr-- <br />Page )-- of l <br />[T;e;stTM�ethodeveloped By: Tank Manufacturer ❑ Industry Standard E, Professional Engineer <br />7 ther (Specifj) <br />Test Method Used: 7.- Pressure acuum ❑ Hydrostatic <br />G Other (Spec) <br />Test Equipment Used: oS i cecau-L— ,�-; U<!rtu % 6e,.rr gra 14 <br />Equipment Resolution: —1 z _3 <br />Tank #_ Tank # 2.- '�5 Tank # anti # <br />Is Tank Exempt From Testing?' <br />❑ Yes o <br />❑ Yes o <br />❑Yes ❑ No <br />❑ Yes ❑ No <br />Tank Capacity: <br />- O ((— <br />; .OI !S I A lo( k o <br />1 <br />Tank Material: <br />,{ u, 1*,5i <br />� e, 5 5 <br />Tank Manufacturer: <br />ru g C O <br />r t~ Sct-) <br />Product Stored: <br />10 Vr <br />9c, � d 'Se � <br />13 <br />Wait time between applying <br />pressur vacuum ater and <br />startin tes : <br />004 V <br />3 <br />Test Start Time: <br />'7 + 3o <br />rV 3 d <br />Initial Reading (RI): <br />10 14 <br />Test End Time: <br />3 d <br />c� e 3 0 <br />Final Reading (RF): <br />9 t} . <br />(�. <br />Test Duration: <br />Change in Reading (RF-Rj): <br />W <br />Pass/Fail Threshold or Criteria: <br />�, r lOf os <br />Baa i c (.4ikroS <br />Test Result: <br />,Pass ❑ Fail <br />Pass ❑ Fail <br />Pass ❑ ail❑ <br />aqSOil <br />Was sensor removed for testing?es <br />❑ No ❑ NA <br />es ❑ No ❑ NA <br />Yes ❑ No NA <br />Eles ElNo ANA <br />Was sensor properly replaced and <br />verified functional after testing? <br />❑ No ❑ NA <br />Yes ❑ No ❑ NA <br />/El ❑ No ❑ <br />Yes ❑ No ❑ A <br />Comments — (include information on repairs made prior to testing and recommended follow-up for failed tests) <br />' Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary <br />containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment <br />testing. {California Code of Regulations, Title 23, Section 2637(a)(6)) <br />