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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 6. SPILL CONTAINER DETAILS <br /> Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum 0 Hydrostatic <br /> Tank ID T-1 unleaded T-2 premium T-3 Diesel <br /> Spill Container Manufacturer: opw opw opw <br /> Method of Cathodic Protection ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> 0 Other 0 Other 0 Other ❑ Other <br /> Is the spill container minimum ® Yes ® Yes ® Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* ® No* E] No* ❑ No* <br /> riser volume? <br /> 0 Drain 0 Drain 0 Drain ❑ Drain <br /> Method to keep spill container ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results <br /> D Pass 0 Pass 0 Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> Method of Cathodic Protection ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* ❑ No* E] No* El No* <br /> riser volume? <br /> ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> Method to keep spill container ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> empty ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other,""No,"or "Fail"and each proposed remedy. <br /> * Mark here if: <br /> ❑ Spill containers do not have a minimum capacity of five gallons and require replacement. <br /> Additional copies of this page may be attached. <br /> Page 2 of 2 <br />