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C <br />4. TANK ANNULAR TESTING <br />Page 2— of 7 <br />Test Method Developed By: <br />❑ Tank Manufacturer ® Industry Standard ❑ Professional Engineer <br />❑ Other (Specify) <br />Test Method Used: <br />❑ Pressure <br />❑ Other (Specify) <br />® Vacuum <br />❑ Hydrostatic <br />Test Equipment Used: DIAL GAUGE <br />Equipment Resolution: 0 to 15" Hg Vacuum <br />Tank # S- 7 <br />Tank # y/ <br />Tank # Tank # <br />Is Tank Exempt From Testing?' <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No ❑ Yes ❑ No <br />Tank Capacity: <br />GALLONS <br />GALLONS <br />GALLONS GALLONS <br />Tank Material:' <br />' <br />Tank Manufacturer: <br />Product Stored:,, <br />Wait time between applying <br />pressure/vacuum/water and <br />starting test: <br />15 Minutes <br />15 Minutes <br />15 Minutes 15 Minutes <br />Test Start Time: <br />C, <br />s� <br />Initial Reading (RI): <br />PC " HG <br />> 0 " HG <br />"HG "HG <br />Test End Time: <br />Final Reading (RF): <br />/ " HG <br />HG <br />"HG "HG <br />Test Duration: <br />1 Hour <br />1 Hour <br />1 Hour 1 Hour <br />Change in Reading (RF-RO: <br />0, " HG <br />a -HG <br />"HG "HG <br />or Criteria: <br />Zero <br />Zero Zero <br />TPass/Fy{ailTgyhy�reshold <br />�Z�ero <br />ett <br />Was sensor removed for testing? ® Yes ❑ No ❑ NA ® Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA <br />Was sensor properly replaced and <br />verified functional after testing? <br />ER Yes ❑ No ❑ NA <br />19 Yes ❑ No ❑ NA <br />❑ Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />Chevron -208117 <br />755 S. Tracy Blvd. <br />Tracy, CA 95376 <br />N05204-SB989 Testing <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 />