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Page 12 of 14 <br /> 16. FILL RISER CONTAINMENT SUMP TESTING <br /> Facility is Not Equipped With Fill Riser Containment Sumps 0 <br /> Fill Riser Containment Sumps are Present,but were Not Tested ❑ <br /> Test Method Developed By: ❑Sump Manufacturer ®Industry Standard ❑Professional Engineer <br /> ❑ Other(Specify) <br /> Test Method Used: ❑Pressure ❑Vacuum ® Hydrostatic <br /> ❑Other(Specify) <br /> Test Equipment Used: Equipment Resolution: <br /> Fill Sump # Fill Sump # Fill Sump# Fill Sump # <br /> Sum 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 testing: <br /> Portion of Sump Tested <br /> Sump Material: <br /> Wait time between applying <br /> pressure/vacuum/water and starting <br /> test: <br /> Test Start Time: <br /> Initial Reading i): <br /> Test End Time: <br /> Final Reading RF <br /> Test Duration: <br /> Change in Reading RF-Ri: <br /> Pass/Fail Threshold or Criteria: <br /> Test Result. ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> Is there a sensor in the sump? Dyes ❑ No ❑Yes ❑ No ❑Yes ❑ No ❑Yes ❑ No <br /> Does the sensor alarm when either ❑Yes ❑ No ❑NA ❑Yes ❑ No ❑ NA ❑Yes ❑ No ❑ NA ❑Yes ❑ No ❑ NA <br /> product or water is detected? <br /> Was sensor removed for testin ? ❑Yes ❑ No ❑NA ❑Yes ❑ No ❑ NA ❑Yes ❑ No ❑ NA ❑Yes ❑ No ❑NA <br /> Was sensor properly replaced after ❑Yes ❑ No ❑NA ❑Yes ❑ No ❑ NA ❑Yes ❑ No ❑ NA ❑Yes ❑ No ❑ NA <br /> testing? <br /> Comments—(include information on repairs made prior to testing,and recommended follow-up for failed tests) <br />