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Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> 6. TANK SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer ❑ Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: NA-Tanks have Brine Filled Tank Secondary Containment <br /> Tank ID 1-Regular 87 2-Plus 89 3-Super 91 <br /> Tank Manufacturer O C Tank O C Tank O C Tank <br /> Tank Capacity 12K 12K 12K <br /> Test Start Time Exempt-bftsc Exempt-bftsc Exempt-bftsc <br /> Initial Reading NA NA NA <br /> Test End Time NA NA NA <br /> Final Reading NA NA NA <br /> Change in Reading NA NA NA <br /> Pass/Fail Criteria NA NA NA <br /> Tightness Test Results ❑ Pass ❑ Fail I ❑ Pass ❑ Fail I ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ® Manufacturer ❑ Industry Standard ❑ Professional Engineer <br /> Test Type ® Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: Pressure Gauges in Psi/Nitrogen <br /> Pipe Run ID 1-Regular 87 2-Plus 89 3-Super 91 <br /> Pipe Manufacturer Ameron FRP Ameron FRP Ameron FRP <br /> Test Start Time 8:35 8:40 8:45 <br /> Initial Reading 3 Psi 3 Psi 3 Psi <br /> Test End Time 9:35 9:40 9:45 <br /> Final Reading 3 Psi 3 Psi 3 Psi <br /> Change in Reading 0 0 0 <br /> Pass/Fail Criteria No Loss No Loss No Loss <br /> Tightness Test Results © Pass ❑ Fail © Pass ❑ Fail ® Pass ❑ Fail ❑ Pass ❑ Fail <br /> Pipe Run ID <br /> Pipe Manufacturer <br /> Test Start Time <br /> Initial Reading <br /> Test End Time <br /> Final Reading <br /> Change in Reading <br /> Pass/Fail Criteria <br /> Tightness Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> Additional copies of this page may be attached. <br /> All tests marked "Fail'and any repairs made before or during the tightness test must be described in <br /> the COMMENTS section. <br /> Page 2of5 <br />