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S WiCB,January 2002 Page '� of <br /> S. FILL RISER CONTAINMENT SUMIP TESTING <br /> Facility is Not EqWpped With Fill Riser Containment SumDs <br /> Fill Riser Containment Sumps are Present,but were Not Tested ❑ <br /> Test Method Developed By: ❑Sump Manufacturer ❑Industry Stand9rd ❑Professional Engineer <br /> ❑Other(Spec) <br /> Test Method Used: ❑Pressure ❑Vacuum ❑Hydrostatic <br /> ❑Other(Spec) <br /> Test Equipment Osed: Equipment Resolutio . <br /> .- ".ti <br /> °' " # Fill SUUI # Fill Sum #ZT <br /> Fill SUn1 # <br /> Sump Diameter: <br /> Sump Depth: <br /> Height from Tank Top to Top of <br /> Hi est Piping Penetration: -" <br /> Height from Tank Top to Lowest <br /> Electrical Penetration: <br /> Condition of sump prior to <br /> testin <br /> - .. <br /> Portion of Sump Tested -- <br /> Sump Material: <br /> Wait time between applying <br /> pressure/vacuum/water and <br /> startin test: <br /> Test Start Time: <br /> Initial Reading(RO: <br /> Test End Time: <br /> Final Reading(RF): <br /> Test Duration: <br /> Change in Reading RF-V <br /> Pass/Fail Threshold or teria: <br /> Test Result: ❑ Pass ❑Fail ❑ Pass ❑Fail ❑ Pass ❑Fail " ❑ Pass ❑Fail <br /> Is-there a sensorj6 the sump? ❑Yes ❑No ❑Yes ❑No ❑Yes ❑No Yes ❑No <br /> Does theseq;&'alarm when fie, <br /> either pro ct or water is ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes C� o ❑NA <br /> detects . <br /> Was ensor removed for testing? ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA D Yes. ❑No ❑NA ❑Yes- ❑No ❑NA <br /> Wh sensor properly replaced and ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA ❑Yes ❑No ❑NA <br /> erified functional after testing? <br /> Comments—(include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />