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SWRCB, January 2002 0 0 <br />Page of <br />Test Method Used: Pressure Vacuum Hydrostatic <br />Other (Specify) <br />Test Equipment Used: Equipment Resolution: <br />Tauk # Tank # Tank # Tank # } <br />Is Tank Exempt From Testing?' I Yes No Yes No Yes No <br />Tank Capacity: Q <br />Tank Material:. . <br />Tank Manufacturer: <br />Product Stored: <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />Test Start Time: <br />Initial Reading jRi): <br />Test End Time: ®1 <br />Final Reading (RF): <br />Test Duration: <br />Change in=itzading (RF -R',): <br />Pass/Fail Threshold or Criteria: <br />I <br />TesR . . _: Pa Fail <br />Pass Fail: <br />Pass Fail <br />Pass Fail <br />Was sensor removed for testing? No NA I <br />Was sensor properly replaced and I <br />verified functional after testing? e No NA I <br />Yes No NA <br />Yes No NA I <br />Yes No NA I <br />Yes No NA <br />Yes No NA <br />Yes No NA <br />Comments- (include information on repairs made prior to tesring, and recommended follow-up for failed tests) <br />i (2 �� , e- <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(a)(6)) <br />