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tL <br />SWRCB, January 2002 <br />117, 700071711 I-LIM <br />Page & of <br />®. <br />A:JLMJJL, 1ena.t — —, —..a. <br />_ —_ <br />Facility is Not Equipped With Fill Riser Containment Sumps <br />❑ <br />Fill Riser Containment Sumps are Present, but were Not Tested ❑ <br />Test Method Developed By: <br />❑ Sump Manufacturer <br />❑ Industry Standard ❑Professional Engineer <br />❑ Other (Specify) <br />Test Method Used: <br />❑ Pressure <br />D Vacuum <br />❑ Hydrostatic <br />❑ Other (Specify) <br />MM <br />t Resolution: <br />TeA Equipment IJ.-;od* <br />+I`�I1 Sump # # <br />Rill Sump # <br />Fill Sump # �/ <br />MSump <br />Sump Diameter: <br />r • <br />be7'r <br />4 <br />SumDe <br />Height from Tank Top to Top of <br />Highest Pi in Penetration: <br />Height from Tank Top to Lowest <br />Electrical Penetration <br />Condition of sump prior to <br />testing: <br />Portion of Sump Tested <br />2" above highest <br />2" above highest <br />2" above highest <br />2" above highest <br />enetration <br />enetration <br />enetrati <br />enetration <br />Sump Material: <br />Wait time between applying <br />pressurelvacuum/water and <br />30 minutes <br />30 minutes <br />30 minutes <br />30 minutes <br />starting test <br />Test Start Time: <br />initial Reading (RD: <br />►?iii 5 �. /� �• ��f� �. �° ®, <br />Test End Time: <br />:A <br />12:19— <br />Final Readin <br />Final <br />► 7 R1 4/ <br />Test Duration: <br />15 minutes <br />15 M MUteS <br />15 m nutes <br />15 m utes <br />Change in ReadingR): <br />. a®tet I- f.®oa <br />� � <br />®t� <br />Pass/Fail Threshold or Criteria <br />0.0020 <br />0.0020 <br />-W—Pass <br />0.0020 <br />0.0020 <br />Test Result: <br />9 Pass - ❑ Fail <br />. ❑ Fail <br />Pass , ❑ Fail <br />❑ Pass ❑ Fail <br />Is there a sensor in the sump? <br />Yes ❑ No <br />KYes ❑ No <br />Yes ❑ No <br />❑ Yes ❑ No <br />Does the sensor alarm when <br />either product or water is <br />❑ Yes ❑ No KNA <br />D Yes ❑ No ;(NA <br />Dyes ❑ No 1LNA <br />❑ Yes ❑ No ❑ NA <br />detected? <br />Was sensor removed for testing? <br />21 Yes D No ❑ NA <br />%Yes ❑ No 11 NA <br />$Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA <br />Was sensor properly replaced and <br />' <br />W�&I,es D No D NA <br />g Yes ❑ No [INA <br />*Yes ❑ No D NA <br />oyes ❑ No [INA <br />verified functional after tes n g? <br />Comments — (inctude information on repairs made prior to testing and recommended follow-up for faiXed tests) <br />Arco #05450 <br />1617 W. Fremont <br />Stockton, Ca <br />Nick Harvey - <br /># 10073 SB 989 <br />