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SRCB,January 2002 Page of <br /> W <br /> 9. SPILL/OVERFILL CONTAMMENT BOXES <br /> Facility is Not Equipp With Spill/Overfill Containment Boxes ❑ <br /> Spill/Overfill Containmgnt Boxes are Present,but were Not Tested ❑ <br /> Test Method Developed By: ❑Spill Bucket Manufacturer ndustry Standard ❑Professional Engineer <br /> ❑Other(Spec) <br /> Test Method Used: ❑Pressure ❑Vacuum Hydrostatic <br /> ❑Other(Spec) <br /> Test Equipment Used: " r 'a Equipment esolut on <br /> qu nt R � <br /> dSHMra �wfirSN("'rah"i!q#'a `QMW `, ass SSM s4A( f #.wt`kr6R'. <br /> k <br /> spill Box# Spill Box# Spill Box# Spill Box# <br /> Bucket Diameter: <br /> Bucket Depth: C/ <br /> Wait time between applying <br /> pressure/vacuum/water and _--- <br /> starting test: <br /> Test Start Time: C <br /> Initial Reading(Ri): <br /> Test End Time: <br /> Final Reading(RF): <br /> Test Duration: ®( <br /> Change in Reading(RF-111): <br /> Pass/Fail Threshold or <br /> Criteria: <br /> Test Result: Pass ❑Fail ❑ Pass ❑Fail Fail ❑ Pass ❑Fail <br /> Commenis—(include information on repairs made prior to testing, and re_c(ommended follow,-up for failed tests) <br /> �' l�S CI C3/ti^a D I J ib i-� 1 Cs Q �3C° <br /> Please direct any comments regarding this form to: <br /> SWRCB UST Program,Attn: Scott Bacon <br /> 1001 "I"Street,Box 944212 <br /> Sacramento,CA 95814 <br /> Phone:(916)341-5873,Fax:(916)341-5808 <br /> e-mail:bacons@cwp.swreb.ca.gov <br />