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J H/`I�LO�GCJ°JJ C!7 GCJ MI'1 Y� b3 <br /> v tG <br /> 4. TANK ANNULAR TESMG <br /> Test Me"Developed By: 0 Tank Manufacturer Standard ❑Professional Engineer <br /> ❑00M(specify) <br /> 'fest Method'uR d., 0 pressure I(vacuum 0 Hydrostatic <br /> ❑other(Specify) <br /> Test Used; , PkPipment R.esolutioz , <br /> Teak j p n' Taub#j !a Tank# Tanh# ti <br /> Is Tank&,bn t From Twdng?= ❑'Yes If No ❑Yes XNo ❑Yes 19 No Q Yes K No <br /> Tank Capacity. <br /> Tank Material: ta 1 ass <br /> Tank Manufacturer. ,f. �„ <br /> Product Stored: Unleaded v r <br /> Walt filne between applying <br /> prossure/vaountn/water and <br /> starting test: )5 MiNAES IS <br /> Test Start Time: q:01 A 1 aA F <br /> Initial Roading OW: jya, in' M )1-5 i h 1 <br /> Test End Time: 1 e A ` U ',34 AL M <br /> Final Reading(Rr) in ' <br /> Test Duration: LAIr i 14 <br /> Change in Reading(Rr-U: e 1 h <br /> e Wq <br /> Pass/Fail Threshold or Criteria: 1,0 Helkf 11 <br /> NNIMMEMa <br /> Was sensor moved for testing? X Yes ❑No ❑NA )f'Y'es ❑No ❑NA, Wyes ❑No ❑NA, ItYes ❑No ❑NA <br /> Was stnsor properly replaced and ❑Yes ❑No NA Yea ❑No <br /> verified functional after testin ® ' `IA ❑Yes ❑No �NA ❑Ya ❑NoTq <br /> COMMents— nclude f ion on re airs madeprior to testing,andrecommE24!4,folkw-Wforfallediesy2 <br /> a 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 r <br /> testing. {California Code of Regulations,Title 23,Section 2637(a)(6)1 <br /> Pace 2 of 7 1/t 3lZ�03 <br />