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Underground Storage Tank <br />Secondary Containment Testing Report Form <br />8. SUMP/UDC TEST (continued) <br />Test Method Developed by ❑ Manufacturer ❑ Industry Standard ® Professional Engineer <br />Test Type ❑ Pressure ❑ Vacuum ® Hydrostatic <br />Test Equipment Used: Caldwell Level Change Indicator <br />Sump/UDC ID <br />1 -87 -FS <br />2 -91 -FS <br />3-Dsl-FS <br />Sump Manufacturer <br />Western FG <br />Western FG <br />Western FG <br />Sump Depth (inches) <br />39" <br />38" <br />40" <br />Sump Bottom to Top of <br />Highest Pipe Penetration <br />(inches) <br />15" <br />17" <br />14" <br />Test Start Time <br />11:42 <br />11:47 <br />12:22 <br />Initial Reading <br />.001 <br />.001 <br />.001 <br />Test End Time <br />12:12 <br />12:17 <br />12:52 <br />Final Reading <br />.001 <br />.001 <br />.001 <br />Change in Reading <br />0 <br />0 <br />0 <br />Pass /Fail Criteria <br />No Loss <br />No Loss <br />No Loss <br />❑ Pass ❑ Fail <br />Tightness Test Results <br />® Pass ❑ Fail <br />® Pass ❑ Fail <br />® Pass ❑ Fail <br />❑ Pass ❑ Fail <br />Sump/UDC ID <br />Sump Manufacturer <br />Sump Depth (inches) <br />Sump Bottom to Top of <br />Highest Pipe Penetration <br />(inches) <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 may be 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 4 of 5 <br />