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y � c <br /> SWRC , January 2002 <br /> Page of <br /> RISERS. FILL T <br /> Facility is Not Equipped With Fill Riser Containment Sum s <br /> Fill Riser Containment Sumps are Present,but were Not Tested ❑ <br /> est ethod Developed By: ❑Sump Manufacturer ❑Industry Standard ❑Professional Engineer <br /> ❑Other(Speck) <br /> Test Me d Used: ❑Pressure ❑Vacuum ❑Hydrostatic <br /> ❑Other(Spec) <br /> Test Equipment Used, Equipment Resotut. <br /> Fill Sump# Fill Sume# Fill Sum Fill Sum # <br /> Sump Diameter: <br /> Sump Depth: <br /> Height from Tank Top to Top of <br /> Highest Piping Penetration: <br /> Height from Tank Top to Lowest <br /> Electrical Penetration: <br /> Condition of sump prior to <br /> testing. <br /> Portion of Sump Tested <br /> Sump Material: <br /> Wait time between applying <br /> pressure/vacuum/water and <br /> starting test: <br /> Test Start Time: <br /> Initial Reading(R,): <br /> Test End Time: <br /> Final Reading(RF): <br /> Test Duration: <br /> Chane in Reading RF- <br /> Pass/Fail Threshold or riteria: <br /> Test Result: ❑ Pass ❑Fail ❑ Pass ❑Fail ❑ Pass ❑Fall Pass ❑Fail <br /> Is there a sennX sensor' the sump? ❑Yes ❑No ❑Yes ❑No ❑Yes ❑No ❑ s ❑No <br /> Does the sena alarm when <br /> either prod or water is ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA 0 Yes ❑ ❑NA <br /> detected? <br /> Was se or removed for testing? ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑ <br /> Was nsor properly replaced and <br /> verified functional after testing, <br /> ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA <br /> Comments®(include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />