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FEB/24/2021/WED 06: 06 PM Tracy Truck Stop FAA' No, 209832 2312 P, 006 <br /> Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> e { i,,�,l;!.i,,i��',�, 4�,!;►i ����1�,��i !�!, .�!��!��! � b���,��� � a ��4�:al i 51 <br /> Test Method Developed by ❑ Manufacturer ❑ Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: <br /> Sump/UDC ID <br /> Sump Manufacturer <br /> Sump Depth (inches) <br /> Sump Bottom to Top of <br /> Highest Pipe Penetration <br /> (inches) <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 11 Pass ❑ Fail <br /> Sump/UDC ID <br /> Sump Manufacturer <br /> Sump Depth (inches) <br /> Sump Bottom to Top of <br /> Highest Pipe Penetration <br /> (inches) <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 CJ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail =PassFail <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 bedescribed in <br /> the COMMENTS section_ <br /> Received Time Feb, 24. 2021 6 : 02PM No. 6614 Page 3of5 <br />