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Underground Storage Tank Secondary Containment Testing Report Form 6. TANK SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional Engineer Test Type ❑ Pressure 0 Vacuum ❑ Hydrostatic Test Equipment Used:vacuum Tank ID 87 89 91 Diesel Tank Manufacturer Modern Welding Modern Welding Modern Welding Modern Welding Tank Capacity 12,000 12,000 12,000 12,000 Test Start Time 8:40 am 8:40 am 10:00 am 10:00 am Initial Reading 10 Hg 10 Hg 10 Hg 10 Hg Test End Time 9:40 am 9:40 am 11:00 am 11:00 Hg Final Reading 10 Hg 10 Hg 10 Hg 10 Hg Change in Reading o 0 0 0 Pass/Fail Criteria o 0 0 0 Tightness Test Results p Pass ❑ Fail 0 Pass ❑ Fail 0 Pass ❑ Fail 0 Pass ❑ Fail 7. PIPE SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional Engineer Test Type 0 Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used:Pressure guage Pipe Run ID 87 East 87 West 89 East 89 West Pipe Manufacturer Environ Environ Environ Environ Test Start Time N/A N/A N/A N/A Initial Reading N/A N/A N/A N/A Test End Time N/A N/A N/A N/A Final Reading N/A N/A N/A N/A Change in Reading N/A N/A N/A N/A Pass/Fail Criteria o 0 0 0 Tightness Test Results ❑ Pass 0 Fail ❑ Pass 0 Fail ❑ Pass 0 Fail ❑ Pass 0 Fail Pipe Run ID 91 East 91 West Diesel Pipe Manufacturer Environ Environ Environ Test Start Time N/A N/A N/A Initial Reading N/A N/A N/A Test End Time N/A N/A N/A Final Reading N/A N/A N/A Change in Reading N/A N/A N/A Pass/Fail Criteria o 0 0 Tightness Test Results ❑ Pass 0 Fail ❑ Pass 0 Fail ❑ Pass 0 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 2 of 5