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SWROB, January 2002 <br />Test Method Developed By: <br />Test Method Used: <br />Test Equipment Used: &c, y } <br />ank Manufacturer ❑ Industry Standard <br />❑ Other (Specie) <br />❑ Pressure gyacuum <br />❑ Other (Spec) <br />a4- t( -VO ! V4.Cttcaae �> Ea,A1t.a tU. I Eau <br />Page -�— of 7 <br />❑ Professional Engineer <br />❑ Hydrostatic <br />Resolution: — I t 2,, - 3 a <br />Tank # £ Z <br />Tank # 3 -Tank <br />Tank # # .. <br />Is Tank Exempt From Testing?' <br />❑ Yes o <br />❑ Yesto <br />❑ Yes ❑ No }, ❑ Yes ❑ No <br />Tank Capacity: <br />to V -g DI Z t <br />Tank Material: <br />u 5 �l <br />Tank Manufacturer: <br />C L �' -I' j <br />Product Stored: <br />i2 e E a/ �IA c y <br />ID i z s eL- <br />Wait <br />:';e=napplying <br />pressater and <br />startin test: <br />i a u. y <br />Test Start Time: <br />V . - O <br />0 " ` OD <br />Initial Reading (RO: <br />10 <br />_ , <br />fb <br />Test End Time: <br />01, <br />Final Reading (RF): <br />1 E F <br />Test Duration: <br />Change in Reading (RF -RAJ: <br />l_ <br />Pass/Fail Threshold or Criteria: <br />r., J L,0 74 <br />Jos 11 - <br />Test Result: <br />XPa93 ❑ ean <br />WTass ❑ Fail <br />Pass ❑Fail Pass ❑ Fa <br />Was sensor removed for testing?es <br />❑ No ❑ NA <br />es ❑ No ❑ NA <br />Yes ❑ No ❑ Yes ❑ No ❑ N <br />Was sensor properly replaced and <br />• <br />verified functional after testing? <br />Yes ❑ No ❑ NA <br />es ❑ No ❑ NA <br />❑ Ye ❑ No ❑ NA ❑ Yes ❑ No ❑ NA, <br />COmmelits — (include information on repairs made prior to testing, and recommended follow up for 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(x)(6)} <br />