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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 DSL 1 DSL 2 <br /> Spill Container Manufacturer 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 El Other ❑ Other ❑ Other <br /> Is the spill container minimum <br /> capacity five gallons excluding El Yes ❑ Yes ❑ Yes ❑ Yes <br /> riser volume? ❑ No* ❑ No* ❑ No* ❑ No* <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 all 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 7 of 7 <br />