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From: Belshire Environment Fax: (M) 460-5210 To: 12094683433@tcfax.c(; Fax; +12094683433 Page 3 of 8 0WW2015 9:23 AM <br />TANK ANNULAR TESTING <br />Test Method Developed By: 0 Tank Manufacturer 0 Industry Standard 0 Professional Engineer <br />0 Other (Specify) <br />Test Method Used: 0 Pressure 0 Vacuum 0 Hydrostatic <br />0 Other (Specify) I --- Equipment Resolution: 0.5% of sp. <br />Test Equipment Used: Test plugs, venturi pump and gauges <br />Diesel <br />J r -4e <br />�. .1WE @—I I If IL-" <br />TR <br />Initial Reading (RO: <br />Test End Time: <br />Final Reading (R,,), <br />Test Duration: <br />Change in Reading (RrRD: <br />Pass/Fail Threshold or Criteria: <br />Test Result: Not Tested <br />Was sensor removed for testing? <br />Was sensor properly replaced and <br />verified functional of testing? I I I <br />Comments — (include Information on repairs made prior to testing and reconnnendedfollow-upfELalled tests) <br />Exempt from testing - Continuously Monitored <br />1 Secondary containment systems where the continuous momtonng automatically monitors both the primary and secondary <br />containment such as systems that are lryftstatically monitored or under constant vacuum, are exempt from periodic containment <br />testing. (California Code of Regulations, Title 23, Section 2637(a)(6)) <br />