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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 ❑ Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: N/A <br /> Tank ID 87-1 Annular Wet 87-2 Annular Wet 91 Annular Wet Diesel Annular Wet <br /> Tank Manufacturer <br /> Tank Capacity <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 ❑ Pass ❑ Fail I ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional Engineer <br /> Test Type El Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: Pressure Gauge <br /> Pipe Run ID 87-1 A Product 87-1 B Product 87-2 A Product 87-2 B Product <br /> Pipe Manufacturer Ameron Ameron Ameron Ameron <br /> Test Start Time 10:15 am 10:15 am 10:15 am 10:15 am <br /> Initial Reading 5 psi 5 psi 5 psi 5 psi <br /> Test End Time 11:15 am 11:15 am 11:15 am 11:15 am <br /> Final Reading 5 psi 5 psi 5 psi 5 psi <br /> Change in Reading 0 0 0 0 <br /> Pass/Fail Criteria 0 0 0 0 <br /> Tightness Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> Pipe Run ID 91 A Product 91 B Product Diesel Product <br /> Pipe Manufacturer Ameron Ameron Ameron <br /> Test Start Time 10:15 am 10:15 am 10:15 am <br /> Initial Reading 5 psi 5 psi 5 psi <br /> Test End Time 11:15 am 11:15 am 11:15 am <br /> Final Reading 5 psi 5 psi 5 psi <br /> Change in Reading 0 0 0 <br /> Pass/Fail Criteria 0 0 0 <br /> Tightness Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ 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 2of5 <br />