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Underground Storage Tank Secondary Containment Testing Report Form 6. TANK SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer © Industry Standard ❑ Professional Engineer Test Type ❑ Pressure © Vacuum ❑ Hydrostatic Test Equipment Used: Vacuum Pump/Vacuum Gauge in Hg. Tank ID 1-87/91/Dsl Tank Manufacturer Modern Wid Tank Capacity 22K 3 Compt Test Start Time 8:30 Initial Reading -10" Hg. Test End Time 10:30 Final Reading -10" Hg. Change in Reading 0" Hg. Pass/Fail Criteria No Loss Tightness Test Results ® Pass ❑ Fail I ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail 7. PIPE SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer Test Type ® Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used: Pressure Gauges in Psi/Nitrogen Pipe Run ID 1-87-Product 2-87-Vent 3-Gas Vapor 4-91-Product Pipe Manufacturer Ameron Ameron Ameron Ameron Test Start Time 8:35 8:35 8:35 8:40 Initial Reading 5 Psi 5 Psi 5 Psi 5 Psi Test End Time 9:35 9:35 9:35 9:40 Final Reading 5 Psi 5 Psi 5 Psi 5 Psi Change in Reading 0 Psi 0 Psi 0 Psi 0 Psi Pass/Fail Criteria No Loss No Loss No Loss No Loss Tightness Test Results © Pass ❑ Fail © Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail Pipe Run ID 5-91 Vent 6-Dsl-Prod 7-Dsl-Vent Pipe Manufacturer Ameron Ameron Ameron Test Start Time 8:40 8:45 8:45 Initial Reading 5 Psi 5 Psi 5 Psi Test End Time 9:40 9:45 9:45 Final Reading 5 Psi 5 Psi 5 Psi Change in Reading 0 Psi 0 Psi 0 Psi Pass/Fail Criteria No Loss No Loss No Loss Tightness Test Results © Pass ❑ Fail © Pass ❑ Fail ® Pass ❑ Fail ❑ Pass ❑ Fail Additional copies of this page may be attached. All tests marked "Fail'and any repairs made before or during the tightness test must be described in the COMMENTS section. Page 2of5