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1. TANK ANNULAR TESTING <br />17J <br />Page 2 of 8 <br />Is Tank Exempt From Testing?' <br />❑ Yes ®No <br />❑ Yes ® No <br />❑ Yes ❑ No <br />❑ Yes U No <br />Tank Capacity: <br />Tank Material: <br />Fiberglass <br />Fiberglass <br />Tank Manufacturer: <br />Product Stored: <br />Regular <br />Premium <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />30 minutes <br />30 minutes <br />Test Start Time: <br />8:17AM <br />8:34AAI <br />Initial Reading (RI):. <br />1OHG <br />10HG <br />Test End Time: <br />9:17AM <br />9:34AM <br />Final Reading (RF): <br />10 HG <br />10HG <br />Test Duration: <br />1 hour <br />1 hour <br />Change in Reading (RF -RI): <br />0 <br />0 <br />Pass/Fail Threshold or Criteria: <br />0.00 <br />0.00 <br />0.00 <br />0.00 <br />Test Result: <br />® Pass ❑ Fail <br />® ass ❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass . ❑ Fail <br />Was sensor removed for testing? <br />[—]Yes ❑No ❑NA <br />[:j Yes ❑No DNA <br />❑Yes [:]No [:INA <br />[—]Yes ❑No ❑NA <br />Was sensor properly replaced and <br />verified functional after testing? <br />❑Yes ❑No ❑NA <br />❑Yes []No ❑NA <br />❑Yes ❑No RNA <br />❑Yes ❑No ❑NA <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <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. {California Code of Regulations, Title 23, Section 2637(a)(6)) <br />