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Underground Storage Tank <br />Secondary Containment Testing Report Form <br />6. TANK SECONDARY CONTAINMENT TEST <br />Test Method Developed by 0 Manufacturer E] Industry Standard © Professional Engineer <br />Test Type 0 Pressure ❑ Vacuum ❑Q Hydrostatic <br />Test Equipment Used: <br />Tank ID <br />Tank Manufacturer <br />Tank Capacity <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 <br />0 Pass 0 Fail <br />0 Pass Fail <br />0 Pass 0 Fail <br />❑ Pass C Fail <br />7. PIPE SECONDARY CONTAINMENT TEST <br />Test Method Developed by Manufacturer © Industry Standard © Professional Engineer <br />Test Type © Pressure 0 Vacuum © Hydrostatic <br />Test Equipment Used: <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 <br />© Pass © Fail <br />© Pass 0 Fail <br />I ❑] Pass Ij Fail <br />❑ 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 <br />0 Pass 0 Fail <br />C Pass r] Fail <br />I 0 Pass ❑ Fail <br />C Pass 0 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 2 of 5 <br />