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i <br />4. <br />Page —2—of _2_ <br />TANK ANNULAR TESTING <br />Test Method Developed By: <br />❑ Tank Manufacturer ® Industry Standard D Professional Engineer <br />D Other (Specifi-) <br />Test Method Used: <br />D Pressure <br />D Other (Specify) <br />® Vacuum D Hydrostatic <br />Test Equipment Used: DIAL. GAUGE <br />Tank #DIESEL <br />Is Tank Exempt From Testing?' ® Yes ® No <br />Equipment Resolution: .05 <br />Tank # Tank # Tank # <br />D Yes D No D Yes D No D Yes D No <br />Tank Capacity: <br />15.000 GAL, <br />Tank Material: <br />STEEL / FIBERGLASS <br />Tank Manufacturer: <br />JOOR <br />Product Stored: <br />DIESEL <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />15 MIN <br />Test Start Time: <br />9:15AM <br />Initial Reading (Rj): <br />7.5" VAC <br />Test End Time: <br />10:15AM <br />Final Reading (RF): <br />7.5" VAC <br />Test Duration: <br />1 HR <br />Change in Reading (RF-Rj): <br />0 <br />Pass/Fail Threshold or Criteria: <br />0 <br />0 0 <br />0 <br />Test Result: <br />® Pass D Fail <br />D Paas D Fal! D Pass D Fail <br />D Pass D Fail <br />Was sensor removed for testing? <br />®Yes D No DNA <br />D Yes D No D NA D Yes D No D NA <br />D Yes ONO D NA <br />Was sensor properly replaced and <br />verified functional after testin IL— <br />®Yes D No DNA <br />D Yes D No D NA D Yes D No D NA <br />D Yes D No D NA <br />Comments — (include information on repairs made prior to testing and recommended follow-up far 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)1 <br />