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Underground Storage Tank Secondary Containment Testing Report Form 16. TANK SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer ❑ Industry Standard ❑ Professional Engineer Test Type ❑ Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used: Tank ID 87A Additive Line 87B Additive Line 87A Vent Line Tank Manufacturer Ameron Ameron Ameron Tank Capacity 1:50pm 1:50pm 1:50pm Test Start Time 5 PSI 5 PSI 5 PSI Initial Reading 2:50pm 2:50pm 2:50pm Test End Time 5 PSI 5 PSI 5 PSI Final Reading 0 PSI 0 PSI 0 PSI Change in Reading 0 PSI 0 PSI 0 PSI Pass/Fail Criteria ❑ Pass ❑ Fail 2 Pass ❑ Fail hel Pass ❑ Fail hel Pass ❑ Fail Tightness Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail 17. PIPE SECONDARY CONTAINMENT TEST Test Method Developed by 52 Manufacturer ❑ Industry Standard ❑ Professional Engineer Test Type 52 Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used: Pipe Run ID 87A Additive Line 87B Additive Line 87A Vent Line Pipe Manufacturer Ameron Ameron Ameron Test Start Time 1:50pm 1:50pm 1:50pm Initial Reading 5 PSI 5 PSI 5 PSI Test End Time 2:50pm 2:50pm 2:50pm Final Reading 5 PSI 5 PSI 5 PSI Change in Reading 0 PSI 0 PSI 0 PSI Pass/Fail Criteria 0 PSI 0 PSI 0 PSI Tightness Test Results ❑ Pass ❑ Fail 2 Pass ❑ Fail hel Pass ❑ Fail hel Pass ❑ Fail Pipe Run ID Pipe Manufacturer Test Start Time Initial Reading Test End Time Final Reading Change in Reading Pass/Fail Criteria 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 2 of 5