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SWRCR, January 2002 0 %_ PTPTNf_ CYTMU 'rV Q rYXTr Page of Comments — (include i� formation on repairs made prior to testing and recommended follow-up for failed tests) 1 If the entire depth of the sump is not tested, specify how much was tested. If the answer to Au of the questions indicated with an asterisk (*) is "NO" or "NA", the entire sump must be tested. (See SWRCB LG -160) LV E u \ V Test Method Developed By: ❑ Sump Manufacturer ndustry Standard ❑ Professional Engineer ❑ Other (Specify) Test Method Used: C Pressure ❑ Vacuum C -Hydrostatic ❑ Other (Specify)Test Equipment Used Equipment Resolution �,�� j • �T4� -.Z � Y3 A3.f+•.l^��"A i� .[ . i .. W lw,.. . b _ tr.'... .yf y....;w.i #+y t :+: � ...i, .5.�'�:. r :i.+i'f- _.n ",',�.• Sump # Sump # ,..-•.., _,... Sump # Sump # Sump Diameter: �3 Zai - Sump Depth: S Sump Material: PL1 Height from Tank Top to Top of Highest Pi in Penetration: it 13 Height from Tank Top to Lowest Electrical Penetration: Condition of sump prior to testing: L Portion of Sump Tested' 't AQbOQ doo �- Does turbine shut down when sump sensor detects liquid (both product and water)?* C Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA ❑ Yes ❑ No 0 NA ❑ Yes ❑ No ❑ NA Turbine shutdown response time Is system programmed for fail-safe shutdown? ❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA Was fail-safe verified to be operational?* ❑ Yes ❑ No CNA ❑ Yes ❑ No ❑ 17A ❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA Wait time between applying pressure/vacuum/water and starting test: P r-, 1 Test Start Time: SSS Initial Reading (Rj): Test End Time: !� Final Reading (RF): Test Duration: o M t Change in Reading (RF-R,).- RF-RI):Pass/Fail Pass/FailThreshold or Criteria: Test Result: ET, Pass ❑ Fail ❑ Pass ❑ Fail ❑ .Pass ❑ Fail ❑ Pass D Fail Was sensor removed for testing? ?T -es ❑ No ❑ NA ❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA Was sensor properly replaced and verified functional after testin ? J�,Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA Comments — (include i� formation on repairs made prior to testing and recommended follow-up for failed tests) 1 If the entire depth of the sump is not tested, specify how much was tested. If the answer to Au of the questions indicated with an asterisk (*) is "NO" or "NA", the entire sump must be tested. (See SWRCB LG -160)