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Page :—?-of 7 <br />4. TANK ANNULAR TESTING <br />Test Method Developed By: <br />❑ Tank Manufacturer ® Industry Standard ❑ Professional Engineer <br />❑ Other (Specify) <br />Test Method Used: <br />❑ Pressure <br />® Vacuum <br />❑ Hydrostatic <br />❑ Other (Specify) <br />Test Equipment Used: DIAL GAUGE <br />Equipment Resolution: 0 to 15" Hg Vacuum <br />Tank 87 C<�-7 <br />Tank g <br />Tank Tank <br />Is Tank Exempt From Testing?' <br />❑ Yes R -Ko <br />❑ Yes o <br />❑ Yes ❑ No ❑ Yes ❑ No <br />Tank Capacity: <br />!i" GALLONS <br />j 5 ` GALLONS <br />GALLONS GALLONS <br />Tank Material: <br />vo� " & <br />--` --- <br />Tank Manufacturer: <br />Product Stored: <br />Wait time between applying <br />pressurelvacuum/water and <br />15 Minutes <br />15 Minutes <br />15 Minutes 15 Minutes <br />starting test: <br />Test Start Time: <br />7. 0 <br />7.',36) <br />Initial Reading (RI): <br />-HG <br />HG <br />"HG "HG <br />Test End Time: <br />a: u o <br />Final Reading (RF): <br />" HG <br />HG <br />"HG "HG <br />Test Duration: <br />h0 <br />11(10; <br />Change in Reading (RF-RO: <br />" HG <br />" HG <br />"HG "HG <br />Pass/Fail Threshold or Criteria: <br />Zero <br />Zero <br />Zero Zero <br />t�-x <br />Was sensor removed for testing? <br />® Yes ❑ No ❑ NA <br />® Yes ❑ No ❑ NA <br />® Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA <br />Was sensor properly replaced and <br />® Yes ❑ No ❑ NA <br />® Yes ❑ No ❑ NA <br />® Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA <br />verified functional after testing? <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />Chevron #99840 <br />4344 Waterloo Rd. <br />Stockton, CA. 95215 <br />N04770 — SB 989 Testing <br />1 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 <br />testing. (California Code of Regulations, Title 23, Section 2637(a)(6) ) <br />