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Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> Test Method Developed by ❑ Manufacturer 0 Industry Standard X Professional Engineer <br /> ' Test Type ❑ Pressure ❑ Vacuum X Hydrostatic <br /> ' Test Equipment Used: Cadwell Level indicator, test fluid (11-1120) — - - <br /> Sump/UDC ID Regular STP Supreme STP Diesel STIP lent sump <br /> Sump Manufacturer unknown unknown unknown unknown <br /> Sump Depth (inches) 47t' 4819 14811 269. <br /> Sump Bottom to Top of 2011 <br /> 01 <br /> * Wo •l <br /> Highest Pipe Penetration <br /> inches <br /> Test Start Time 30 minutes 34 minutes 30 minutes 30 minutes <br /> Initial Reading first circle first circle first circle first circle <br /> Test Fred Time 0 minutes 0 minutes 0 minutes 0 minutes <br /> t Final Reading no change no change no change no change <br /> Charge in Reading 0 � 0 0 — . <br /> Pass/Fail Criteria 0.002130min /3 rains o. o l30mins . /3 mins <br /> Tightness Test Results X Pass ❑ Fail X Pass ❑ Fail X Pass ❑ Fail X Pass ❑ pail <br /> uMP/UDC lD Regular fill Supreme fill Diesel fill 1 -2 UD <br /> Sump Manufacturer unknown unknown unknown unknown -- <br /> f <br /> Sump Depth (inches) 48}' 48 28'i <br /> i <br /> Stamp Bottom to Top of 12" 1 *' i 121N 17"' <br /> Highest Pipe Penetration � <br /> i <br /> (inches) <br /> Test Start Time *nn minutes 30 minutes 30 rain to 30 milnutes <br /> initial Leading first circle first circle first circle first circle <br /> Test End Time 0 minnutes 0 minutes o minutes 0 minutes <br /> Final Reading no chane no change no change no change <br /> Change in Reading 0 0 <br /> r <br /> Pass/Fail Criteria 0.0 13 mins { .0 l3omin o. l30mins 0.002/3 min <br /> Tightness Test Results Pass ❑ Fail Pass ❑ Fail ° X Pass Cl Fail X Pass Q Fail <br /> Additional copies of this page may .be attached. <br /> All tests marked "Fail ' and any repairs trade before or during the tightness test must be described in <br /> the COMMENTS 11k ENTS se tion. <br /> Page 3 of <br />