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Mar. 19. 2014 10:13AM <br />SWRCB, January 2002 <br />4. TANK ANNULAR TESTING <br />Amok No. 3963 P. 8 <br />Page — of <br />Test Method Developed By: <br />QTank Mamifacturer 0 Industry Standard 0 Professional Engineer <br />0 Other (S� eqfy) <br />Test Method Used-. <br />11 pressure, <br />a Other (Specyy) <br />D Vacuum <br />0 Hydrostatic <br />Test Equipment Used; <br />Equipment Re -solution: <br />Is Tank &empt From Testing?' <br />Tank # 17 <br />0 Yea ONo <br />Tank# <br />0 Yes QNo <br />Tank # Tank# <br />D Yes 0 No 0 yes 0 No <br />Tank Capacity; <br />Tank Material: <br />Tank Manufacturer- <br />V <br />Product Stored. <br />C -m e -4 <br />Wait time between applying <br />pressuiWvacuumAyater and <br />-q!Eqng test: <br />Test Start TIme: <br />4) <br />Initial Reading (RI): <br />Test End Time; <br />_Final Reading (Rp): <br />H6 <br />Test Duration: <br />Change in Reading (RrP4)' <br />Pass/Fall Threshold or 0iteria: <br />Test Result. <br />1§1, Pass 13 Fall <br />Pass D Fail <br />0 Pass —0pao 0 )?as$ 0 Fail <br />Was sensor removed for teStm,97 <br />11 Yes IkNo DNA, <br />Effes o DNA <br />DYes ONO DNA D Yes 0 No 0 NA <br />Was sensor properly replaced and <br />Lverified functional after testine <br />OYes CNo 3(NA <br />0 Yes El No VM <br />OYes ONo DNA DYes QNo DNA <br />Comments — and ide Information on repairs madeRfrLor to La! �in, and recommended )t tests <br />�allow-up ft failed <br />KAAQ I CI MA <br />ENVII30NMENTAL HEALTH <br />DEPARTMENT <br />1 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. fCaWbruin Code of Regulations, Title 23, Section 2637(a)(6)? <br />