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SWRCB, January 2002 <br />d. TANK ANNITLAR TRCTYN(= <br />Page of <br />Test Method Developed By: Manufacturer 0 Industry Standard 0 Professional Engineer <br />❑Xank <br />ther (Specify) <br />Test Method Used: ❑ Pressureacuum C Hydrostatic <br />❑ Other (S eco)/Ir k <br />Test Equipment Used: � laa WZ . dtfit &M r., it 1k! Equipment Resolution: <br />Tank # 1 Tank # Z- 3 Tank #'an k # <br />Is Tank Exempt From Testing?' <br />❑ Yes z<No <br />0 YesNo <br />p Yes ❑ No❑Yes <br />❑ No ,. <br />Tank Capacity: <br />( Z IL <br />12,14$ <br />' <br />Tank Material: <br />64 <br />41' <br />Tank Manufacturer: <br />Product Stored: <br />Wait tim x e@n applying <br />pressure acuum/ ater and <br />stagin to .-=r.... <br />q �ti �� <br />t <br />Sue ¢ I P 1 - <br />) <br />P o v k, <br />' <br />i <br />t <br />Test Start Time: <br />v . -7 r <br />Initial Reading (R,): <br />-m / v jF <br />— l0 / <br />Test End Time: <br />Final Reading (RF): <br />0 ¢f <br />._ 16 *9 <br />Test Duration: <br />,t ����- <br />L, <br />Change in Reading (RF-Ri): <br />� . <br />Pass/Fail Threshold or Criteria: <br />UD Lafs /3'� <br />U SSS �vr f <br />Test Results <br />AKPass 0 Fail <br />Pass ❑ Fail <br />0 P s ❑ Fa <br />0/Pass ❑ Fai <br />Was sensor removed for testing? <br />es 0 No 0 NA <br />es 0 No 0 NA <br />0& 0 No❑ <br />❑ es 0 No 0 N <br />Was sensor properly replaced and <br />verified functional after testin ? <br />9LY" El No ❑ NA <br />Yes 0 No O NA <br />❑ es ❑ No ❑ N <br />Yes 0 No <br />—2ij <br />in <br />Comments — (include information on repairs made prior to testing, and recommended follow-up ffor failed tests) <br />' 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 />