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Underground Storage Tank Secondary Containment Testing Report Form 6. TANK SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer © Industry Standard ❑ Professional Engineer Test Type ❑ Pressure © Vacuum ❑ Hydrostatic Test Equipment Used: Vacuum Pump/Vacuum Gauges in Hg. Tank ID 1-87/91 2 -Diesel 3-91 Product 4 -91 -Vent Tank Manufacturer Joor Joor Smith Smith Tank Capacity 10K 2 Compt. 12K 11:51 11:33 Test Start Time 11:45 11:55 5 Psi 5 Psi Initial Reading -6" Hg. -6" Hg. 12:51 12:33 Test End Time 12:45 12:55 5 Psi 5 Psi Final Reading -6" Hg. -6" Hg. 0 Psi 0 Psi Change in Reading 0" Hg. 0" Hg. No Loss No Loss Pass/Fail Criteria No Loss No Loss ® Pass ❑ Fail ® Pass ❑ Fail Tightness Test Results ® Pass ❑ Fail I ® Pass ❑ Fail ❑ Pass ❑ Fail I ❑ Pass ❑ Fail 17. PIPE SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer Test Type ® Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used: Pressure Gauges in Psi/Nitrogen Pipe Run ID 1-87 Product 2-87 Vent 3-91 Product 4 -91 -Vent Pipe Manufacturer Smith Smith Smith Smith Test Start Time 11:48 11:30 11:51 11:33 Initial Reading 5 Psi 5 Psi 5 Psi 5 Psi Test End Time 12:48 12:30 12:51 12:33 Final Reading 5 Psi 5 Psi 5 Psi 5 Psi Change in Reading 0 Psi 0 Psi 0 Psi 0 Psi Pass/Fail Criteria No Loss No Loss No Loss No Loss Tightness Test Results © Pass ❑ Fail © Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail Pipe Run ID Gas Vapor Dsl Product Dsl Vent Pipe Manufacturer Smith Smith Smith Test Start Time 11:36 11:54 11:39 Initial Reading 5 Psi 5 Psi 5 Psi Test End Time 12:36 12:54 12:39 Final Reading 5 Psi 5 Psi 5 Psi Change in Reading 0 Psi 0 Psi 0 Psi Pass/Fail Criteria No Loss No Loss No Loss 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 2of5