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SWRCB, January 2002 <br />7. <br />01 - <br />Facility is Not Equipped With SpilUOve ill Containment Boxes ❑ <br />Spill/Overfill Containment Boxes are Present, but were Not Tested ❑ <br />Test Method Developed By: <br />❑ Spill Bucket Manufacturer ndustry Standard ❑Professional Engineer <br />❑ Other (Spec) <br />Test Method Used: <br />❑ Pressure F1 Vacuum Hydrostatic <br />❑ Other (Spec) <br />Test Equipment Used: <br />Equipment Resolution: ' 014 <br />=10 W_11'7 <br />Spill Box # ( �1 Sp ill Box # Z SpilfBox # Spilt Box # <br />Bucket Diameter: <br />Bucket Depth: <br />V i 3 <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />Test Start Time: - <br />/2-o( — <br />Initial Reading (Rj): <br />5 3A - <br />Test End Time: <br />o <br />Final Reading (RF): <br />Test Duration: <br />Change in Reading (RF-Ri): <br />Pass/Fail Threshold or <br />Criteria: <br />Test Result- <br />Pass ❑ Fail Pass ❑ Fail <br />❑ Pass ❑ Fail <br />❑ Pass ❑ Fail <br />Commenis — include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />Please direct any comments regarding this form to: <br />SWRCB UST Program, Attn: Scott Bacon <br />1001 "1" Street, Box 944212 <br />Sacramento, CA 95814 <br />Phone: (916) 341-5873, Fax: (916) 341-5808 <br />e-mail: bacons@cwp.swrcb.ca.gov <br />