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Underground Storage Tank <br /> Secondary Containment Testing Report Form <br /> 6. TANK SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ® Manufacturer ❑ Industry Standard ❑ Professional Engineer <br /> Test Type ® Pressure ❑ Vacuum ❑ 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 /> 11 Tightness Test Results ❑ Pass ® Fail El Pass ® Fail ® Pass ® Fail ❑ Pass El Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by 91 Manufacturer ® Industry Standard El Professional Engineer <br /> Test Type ® Pressure ❑ Vacuum ® Hydrostatic <br /> Test Equipment Used: Nitrogen <br /> Pipe Run ID Diesel <br /> Pipe Manufacturer smith <br /> Test Start Time 11:00 AM <br /> Initial Reading 5 PSI <br /> Test End Time 12:00 PM <br /> Final Reading 5 PSI <br /> Change in Reading 0 PSI <br /> Pass/Fail Criteria Pass <br /> Tightness Test Results Pass M Fail ® Pass ® Fail ® Pass M Fail ❑ 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 ❑ Pass M Fail r! Pass ® Fail ® Pass ® Fail ® Pass ® 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 ofd= <br />