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V <br />1CB, January 2002 <br />7. UNDER -DISPENSER CONTAINMENT <br />Tost Method Developed By: <br />Test Method Used: <br />OUDC Manufacturer <br />H Other (Spec]if <br />-6 Pressure <br />0 Other (Specifj) <br />11 Vacuum <br />fe Page <br />LDC)TESTING <br />Standard I] Professional Engineer <br />of <br />Test Equipment Used: k, <br />Equipment Resolution: <br />TJDC # UDC # <br />UDC # <br />TJDC Manufacturef: <br />TJDC Nfaterial: <br />rX <br />"" <br />Ir% <br />Height from 1JDC Bottom to Top <br />N <br />of L]Wi st Piping Penetration: <br />Height front IJDC Bottom <br />k <br />'Pt V <br />to <br />Lowest Elwrit;aj Penetration: <br />V <br />Condition of UDC prior to <br />Punion UDC Tested <br />x <br />of <br />_L1 <br />Does hirbine shut dowu when <br />UDC sensor detects liquid (both <br />1.) Yes 11 No LI NA <br />0 Yes U No IJ NA <br />0 Yes 11 No LINA <br />11NA <br />prod 0 and water)?' <br />Tw Wile shutdo" it rev ouse finle <br />Is system progranuned for fail- <br />safe shutdown?* <br />11es Y 0 No <br />—f es 0 No 11 NA <br />0 Yes 0 No 0 NA <br />0 Yes U No Ii NA <br />Was fail-sak verified to be <br />operational?, <br />❑>-a �JN 0 0 NA <br />0 Yes 0 No DNA <br />0 Yes F3 No D NA <br />D'Yes ONo [INA <br />Wait time between applying <br />pressureA-acmullAvater and <br />starting test <br />iN <br />Test Start Titue: <br />Initial Reading <br />Test End Tillie: <br />Final Reading (RF): <br />Lo <br />Test Duration: <br />-Change in Reading <br />Pass/Fail Threshold or Criteria: <br />Test Resuft:ass <br />0 Fan <br />ass 0 Fail <br />214"s 0 Fail <br />XTass 0 <br />Was sensor removed for testi <br />Kjo <br />- A <br />ti Yes ONo M <br />0 Yes ONO I A <br />' % <br />-Fad <br />0 Yes .0 No A <br />Was sensor properly replaced and <br />verified functional after testing? <br />0 Yes 0 No >TNA <br />ElYes DNo 'I''.1 NA <br />EIYes ON0114A <br />HYes ONo X'4A <br />Comments — (include informalion on repairs made prior to zesfiM and recorrunended follow -u for failed tests) <br />' If the entire depth of the UDC is not tested, specify how much was tested. If the answer to any of the questions indicated mith ail <br />asterisk M is "NO" or "NA", the entire UDC must be tested. (See SWRCB LG -160) <br />