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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 1. SPILL CONTAINER DETAILS <br /> Test Methods Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer <br /> Tank ID 87 91 DSL <br /> Spill Container Manufacturer OPW OPW OPW <br /> Method of Cathodic Protection ® Nonmetallic ® Nonmetallic ® Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ® Yes ® Yes ® Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* ❑ No* ❑ No* ❑ No* <br /> riser volume? <br /> Method to keep spill container ® Drain ® Drain ® Drain ❑ Drain <br /> empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ® Pass ® Pass ® Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer <br /> Method of Cathodic Protection ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* ❑ No* ❑ No* ❑ No* <br /> riser volume? <br /> Method to keep spill container ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 2. COMMENTS <br /> Describe a#answers marked "Other'; `No; or `Fail"and each proposed remedy. <br /> *Mark here if <br /> ❑ Spill containers do not have minimum capacity of five gallons and require replacement. <br /> Page 9 of 9 <br />