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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 Dlndustry Standard ❑Professional Engineer <br />Test Type []Pressure ❑✓ Vacuum ❑Hydrostatic <br />Test Equipment Used: 0 to 30 inch hg. glycerin filled vacuum gauge(s). <br />Tank ID <br />T1 Diesel <br />Tank Manufacturer <br />Owen's Corning <br />Tank Capacity <br />4000 <br />Test Start Time <br />08:30 <br />Initial Reading <br />10 <br />Test End Time <br />09:30 <br />Final Reading <br />10 <br />Change in Reading <br />0 <br />Pass/Fail Criteria <br />0 <br />Tightness Test Results <br />0✓ Pass ❑Fail <br />❑Pass ❑Fail <br />❑Pass ❑Fail <br />❑Pass ❑Fail <br />7. PIPE SECONDARY CONTAINMENT TEST <br />Test Method Developed by ❑Manufacturer0✓ Industry Standard ❑Professional Engineer <br />Test Type❑� Pressure ❑Vacuum ❑Hydrostatic <br />Test Equipment Used: 0 to 15 psi glycerin filled pressure gauge(s). <br />Pipe Run ID <br />Supply line 1 <br />Supply 2 <br />Vent line <br />Pipe Manufacturer <br />A.O.Smith <br />A.O.Smith <br />A.O.SMITH <br />Test Start Time <br />08:20 <br />08:20 <br />08:20 <br />Initial Reading <br />5 <br />5 <br />5 <br />Test End Time <br />09:20 <br />09:20 <br />09:20 <br />Final Reading <br />5 <br />5 <br />5 <br />Change in Reading <br />0 <br />0 <br />0 <br />Pass/Fail Criteria <br />0 <br />0 <br />0 <br />Tightness Test Results <br />0✓ Pass ❑Fail <br />ZPass ❑Fail❑� <br />Pass ❑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 />❑Pass ❑Fail <br />❑Pass ❑Fail <br />❑Pass ❑Fail <br />❑Pass ❑Fail <br />Additional copies of this page maybe 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 />