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May', `9. 2017 4: 12PM Donlee Pump Co No- 7237 P. 6 <br /> Secondary Containment Testing Report Form-Page 5 of 5 <br /> Pass/Fail Threshold or Criteria: <br /> Test Result: 17—Pass; Fail Pass; 0 fail— 0 Pass; 0 Fail C1 Pass; [I Fail <br /> Was leak detection sensor []Yes;Ej No; El Yes;El No; 11 Yes;El Na; El Yes;El No; <br /> prpp�rly replaced and verified as El N/A(Not Removed) E)NIA(Not Removed) E]NIA(Not Removed) [j NIA(Not Removed) <br /> L functional after test�gg? <br /> I. Testing of Spill Buckets D NIA(No spill buckets installed) <br /> jg4fll bucket(s)not tested <br /> Test Method Developed By: []Bucket Manufacturer;El Industry Standard;El PE;[I Other(Sped): <br /> Test Method Used: E]Pressure; [I Vacuum; [I Hydrostatic; []Other(Spew): <br /> Test Equipment Used: Equipment Resolution- <br /> ........ ....... <br /> Bucket it-, Bucket#-. Bucket Ih Bucket N.- <br /> ................. <br /> Bucket Diameter: <br /> Bucket Depth: <br /> Wait time between applying 7 <br /> pressure/vacuum/water and <br /> test: <br /> Test Start Time: 201 <br /> 7 <br /> Initial Reading W: <br /> Test End Time: <br /> Final Reading(RF)- <br /> Change in Reading(RF—N: <br /> Pass/Fail Threshold or Criteria: <br /> Test Result: El Pass; El Fail Q Pass; El Fall D Pass; 0 fall ID PAS1 <br /> J. Additional Information <br /> Were any repairs made to secondary containment systems prior to testing? QYes(describe in"Comments");D No <br /> Were any secondary containment systems unable to be tested? C1 Yes(describe in"Comments"),- No <br /> Is any follow-up action recommended? [1 Yes(describe in"Coinmeuts")ON6 <br /> Was any cleaning of secondary containment systems done? []Yes(describe management of wastewater in"Comments");VzxO <br /> If hydrostatic testing was performed,describe in"Comments"what was done with the water after completion of testing. <br /> Comments,- <br /> Otk�(' Vi&.LV_ A-6 1/on +0 <br /> UN-054-515 www.unldomorg 0=6102 <br />