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FEB.25.2003 10:43AM SCOT CO NO.615 P.18i40 <br />SWRCB, January 3002 <br />.. page of <br />Secondary Containment Testing Report Form - FIlyAL, DRAFT <br />This jorrt is intended fQr arse by contractors perfornris�,�► periodic testing of i1STsecondaty contatnrnent systems. Use the <br />appropriatepages of rhzsform to report resulrsfor all components rested The Cismpletedfors, wriuen testprocedures, and <br />printouts froth tests (if applicable), should be provided to thefadlity owner/operator forsubmircal to the local regulatory c ►ertcy. <br />If hydrostatic testing was performed, describe what was done with the water after completion of rests: <br />w 1 <br />CERTIFICATION OFTECHNICIAN RESPONSIBLE FOR CONDUCTING TMS TESTING <br />To the best of nay knowledge, the facts stated In this do ent are accurate and in full Compliance with legal regalremeM <br />Technician's Siparuro: Date: 12�n <br />1tj <br />