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Underground Storage Tank <br />Spill Container Testing Report Form <br />6. SPILL CONTAINER DETAILS <br />Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer <br />Test Type ❑ Pressure ❑ Vacuum ® Hydrostatic <br />Tank ID <br />91 <br />Spill Container Manufacturer: <br />Phil-tite <br />Method of Cathodic Protection <br />❑ Nonmetallic <br />❑ Nonmetallic <br />❑ <br />Nonmetallic <br />❑ <br />Nonmetallic <br />® <br />Other <br />® <br />Other <br />❑ <br />Other <br />❑ <br />Other <br />Is the spill container minimum <br />® <br />Yes <br />p] <br />Yes <br />❑ <br />Yes <br />❑ <br />Yes <br />capacity five gallons excluding <br />® <br />No* <br />❑ <br />No* <br />❑ <br />No* <br />❑ <br />No* <br />riser volume? <br />Method to keep spill container <br />® <br />Drain <br />❑ <br />Drain <br />❑ <br />Drain <br />❑ <br />Drain <br />❑ <br />Pump <br />® <br />Pump <br />❑ <br />Pump <br />❑ <br />Pump <br />empty <br />❑ <br />Other <br />❑ <br />Other <br />❑ <br />Other <br />❑ <br />Other <br />❑ <br />Pass <br />® <br />Pass <br />F7 <br />Pass <br />F-1 <br />Pass❑ <br />Spill Container Test Results <br />Fail <br />1 ® <br />Fail <br />1 ❑ <br />Fail <br />❑ <br />Fail <br />Tank ID <br />Spill Container Manufacturer: <br />❑ <br />Nonmetallic <br />❑ <br />Nonmetallic <br />❑ <br />Nonmetallic <br />❑ <br />Nonmetallic <br />Method of Cathodic Protection <br />❑ <br />Other <br />® <br />Other <br />❑ <br />Other <br />® <br />Other <br />Is the spill container minimum <br />In <br />Yes <br />❑ <br />Yes <br />❑ <br />Yes <br />❑ <br />Yes <br />capacity five gallons excluding <br />❑ <br />No* <br />El <br />No* <br />®No* <br />❑ <br />No* <br />riser volume? <br />® <br />Drain <br />® <br />Drain <br />® <br />Drain <br />❑ <br />Drain <br />Method to keep spill container <br />® <br />Pump <br />❑ <br />Pump <br />❑ <br />Pump <br />❑ <br />Pump <br />empty <br />❑ <br />Other <br />® <br />Other <br />❑ <br />Other <br />❑ <br />Other <br />® <br />Pass <br />❑ <br />Pass <br />❑ <br />Pass <br />❑ <br />Pass <br />Spill Container Test Results <br />❑ <br />Fail <br />r <br />Fail <br />® <br />Fail <br />I ❑ <br />Fail <br />8. COMMENTS <br />Describe all answers marked "Other," "No," or "Fail' and each proposed remedy. <br />Hydrostatic Test 1 Industry Standard <br />91 Spill container was tested @ 14.5 inches and remained at 14.5 inches after 1 hour. <br />Width of container = 12" <br />Depth of container = 16" <br />Notification Required'sent on 3103121 to EHD <br />This is our testing results. <br />* Mark here if: <br />11-1 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 />