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U , r <br />Jun 24 11 07:06a Eli IV Contactors 12094 342 p.5 <br />SWRCB, January 2002 <br />A _ TANK ANNITT.AR TV9TTNf <br />Page of <br />Test Method Developed By: <br />E Tank Manufacturer Kindustry Standard®C Professional Engineer <br />C Other (Specify) <br />Test Method Used: <br />,)6Pressure <br />D Other (Specify) <br />D Vacuum <br />❑ Hydrostatic <br />Test Equipment Used: <br />Is Tank Exempt From Testing?' <br />Tank # ?7,&1 <br />❑ Yes )d No <br />Tank # <br />❑ Yes D No <br />Equi] hent Resolution: <br />Taub 4 Tank # <br />D' is -O-No 0 Yes D No <br />Tank Capacity: <br />I R- coo <br />_ <br />Tank Material <br />Tank Manufacturer: <br />Product Stored: <br />t <br />_ <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />Test Start Time: <br />PSI- <br />ssTest <br />Initial Reading (Rj): <br />TestEnd Time: <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (RF -RI): <br />Pass/Fail Threshold or Criteria: <br />PA -55 <br />P ss fi )Fad <br />U Yes 'No NA <br />!3 Pass" t31ti"ail <br />❑ Yes ❑ No CNA <br />f3 I s L3.lF`aii , 0 Pass.= <br />❑ S' e 3 No DNA ❑ Yes ❑ No ❑ NA <br />Test Result_ , ..;: <br />Was sensor removed for testing? <br />Was sensor properly replaced and <br />verified functional after testing? <br />❑ Yes ❑ No NA <br />❑Yes []No ❑ NA <br />D 5' w� ❑ No 11 NA ❑Yes ❑ No ❑ NA <br />Comments — (include information on repairs made prior to testing, and recommended bi : w -up for failed tests) <br />Secondary containment systems where the continuous monitoring automatically monitors bo, the primary and secondary <br />containment, such as systems that are hydrostatically monitored or under constant vacuum, are -xempt from periodic containment <br />testing. {California Code of Regulations, Title 23, Section 2637(a)(6)1 <br />