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1A CO -4 2.0 -6 4-XS TV-CU_YZ I vrA ) "Acy r)-t&-03 <br /> 4. TANK ANNULAR TESTING <br /> Test Method Developed By: I9Uank Manufacturer R Industry Standard ❑Professional Engineer <br /> ❑Other(Spec) <br /> Test Method Used: ❑Pressure X Vacuum O Hydrostatic <br /> ❑Other(Specify) <br /> Test Equipment Used: 3.S ri a_CA S Equipment Resolution: Q, I h ) <br /> Tank# Tank# Tank# Tank# <br /> Is Tank Exempt From Testing?' ❑Yes JR No D Yes ISNo D Yes 1KNo D Yes W-WO <br /> Tank capacity: )U 000 (_r C,t )p M G— - I 10, &"I MOOD CrCLI <br /> Tank Material: 1` r l a ss F i r l ' F a beY' s F r !ass <br /> Tank Manufacturer. G -k Q S Xerxes X G x X C Y k 5 <br /> Product Stored: $') U n J a ad e cA %1 Jjv%kaCxdPd S1 U n; u C1 Pr Yv1 <br /> Wait time between applying )rj `y,Gkt.e$ )s K i tMt t.L e S } M1- <br /> t`V1"ta S }5 M i n late-S <br /> pressure/vacuum/water and <br /> starting test: M! h t Vv��{'Yri n }h i 1M(.t,nj M i Y,F M tit.w1, 1`'1(h t c Yv► <br /> Test Start Time: , � F 55 A �}� ? � � � A <br /> Initial Reading(Rt): )a 5 Z ra 0. T-n. C4 10.01 10,0 H <br /> Test End Time: 5 P M )U :5 GM 4 <br /> Ali <br /> Final Reading(RF): )0.5 - '®.® �n,I�, <br /> tied Hd 10.0n- K <br /> Test Duration: )" )4 O tA,yl ) N d �- 1 - H O Ck Y' <br /> Change in Reading(RF-R,): O D I Y1 I� ®.(� I Y1 -� (;}. I <br /> Pass/Fail Threshold or Criteria: a <br /> In 1,v In N) <br /> _. Pass Q Sari �'P3"s"s-: =G1 ltgtl; <br /> Pass:: TJT`atSl <br /> Pass <br /> Was sensor removed for testing? 19 Yes ❑No ❑NA NYes D No ❑NA ' Yes ❑No DNA _KYes ❑No ❑NA <br /> Was sensor properly replaced and <br /> verified functional after testin ? '6�Yes ❑No ❑NA Yes ❑No O NA Ryes ❑No DNA WYes D No DNA <br /> Comments-(include information on repairs made prior to testing and recommended follow up for failed tests) <br /> t Secondary containment systems where the continuous monitoring an 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(x)(6)} llyj� <br />