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I v/ Page 2 of 9 Test Method Developed By: ❑ Tank Manufacturer ® Industry Standard ❑ Professional Engineer ❑ Other (Specify) Test Method Used: ❑ Pressure ® Vacuum ❑ Hydrostatic ❑ Other (Specify) Test Equipment Used: Vacuum Gauge 10 min Equipment Resolution: 0-30 Hg 10 min Test Start Time: 10:25 AM 9:50 AM 10:00 AM Tank #87 Tank # 87 Syphone Tank # 91 Tank # Is Tank Exempt From Testing?' ❑ Yes ® No ❑ Yes ® No ❑ Yes ® No ❑ Yes ❑ No Tank Capacity: 12000 Gal 12000 Gal 12000 Gal 7 Hg Tank Material: D/W Steel DMI Steel DMI Steel 60 min Tank Manufacturer: Unknown Unknown Unknown 0 Product Stored: Unleaded 87 Unleaded 87 Unleaded 91 7 Hg Wait time between applying pressure/vacuum/water and starting test: 10 min 10 min 10 min Test Start Time: 10:25 AM 9:50 AM 10:00 AM Initial Reading (Rj): 7Hg 7Hg 7Hg Test End Time: 11:25 AM 10:50 AM 11:00 AM Final Reading (RF): 7 Hg 7 Hg 7 Hg Test Duration: 60 min 60 min 60 min Change in Reading (RF-Rj): 0 0 0 Pass/Fail Threshold or Criteria: 7 Hg 7 Hg 7 Hg Test Result: ® Pass ❑ Fail 0 Pass ❑ Fail ® Pass El Fail ❑ Pass ❑ Fail Was sensor removed for testing? ®Yes [—]No [:INA ®Yes ❑No ❑NA ®Yes ❑No ❑NA ❑Yes ❑No ❑NA Was sensor properly replaced and verified functional after testing? ®Yes ❑No [-INA ®Yes ❑No ❑NA ®Yes ❑No ❑NA ❑Yes ❑No ❑NA Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment testing. {California Code of Regulations, Title 23, Section 2637(a)(6)}