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Underground Storage Tank <br />Spill Container Testing Report Form <br />6. SPILL CONTAINER DETAILS <br />Test Method Developed by p <br />Manufacturer ® Industry Standard <br />❑ <br />Professional Engineer <br />Test Type ❑ <br />Pressure ❑ Vacuum <br />® <br />Hydrostatic <br />Tank ID <br />879-TFUG01 <br />879-TFUD01 <br />Spill Container Manufacturer: <br />OPW <br />OPW <br />Method of Cathodic Protection <br />® Nonmetallic <br />❑ Nonmetallic <br />❑ <br />Nonmetallic <br />❑ <br />Nonmetallic <br />® Other <br />® Other <br />In <br />Other <br />❑ <br />Other <br />Is the spill container minimum <br />® Yes <br />® Yes <br />❑ <br />Yes <br />❑ <br />Yes <br />capacity five gallons excluding <br />❑ No* <br />❑ No* <br />❑ <br />No* <br />❑ <br />No* <br />riser volume? <br />Method to keep spill container <br />❑ Drain <br />® Drain <br />❑ <br />Drain <br />❑ <br />Drain <br />❑ Pump <br />® Pump <br />❑ <br />Pump <br />❑ <br />Pump <br />empty <br />❑ Other <br />❑ Other <br />❑ <br />Other <br />❑ <br />Other <br />0 Pass <br />® Pass <br />❑ <br />Pass <br />❑ <br />Pass <br />Spill Container Test Results <br />❑ Fail <br />❑ Fail <br />❑ <br />Fail <br />❑ <br />Fail <br />Tank ID <br />Spill Container Manufacturer: <br />Method of Cathodic Protection <br />❑ Nonmetallic <br />❑ Nonmetallic <br />❑ <br />Nonmetallic <br />❑ <br />Nonmetallic <br />❑ Other <br />❑ Other <br />® <br />Other <br />® <br />Other <br />Is the spill container minimum <br />❑ Yes <br />❑ Yes <br />® <br />Yes <br />In <br />Yes <br />capacity five gallons excluding <br />®No* <br />®No* <br />r] <br />No* <br />®No* <br />riser volume? <br />On Drain <br />❑ Drain <br />❑ <br />Drain <br />❑ <br />Drain <br />Method to keep spill container <br />® Pump <br />❑ Pump <br />® <br />Pump <br />❑ <br />Pump <br />empty <br />❑ Other <br />❑ Other <br />❑ <br />Other <br />❑ <br />Other <br />Spill Container Test Results <br />❑ Pass <br />❑ Pass <br />❑ <br />Pass <br />❑ <br />Pass <br />❑ Fail <br />❑ Fail <br />❑ <br />Fail <br />❑ <br />Fail <br />8. COMMENTS <br />Describe all answers marked "Other," "No,"or "Fail' and each proposed remedy. <br />Using the Caldwell Sump Level Change Indicator from: <br />TFUG01: 10:12a @ 12.25" to 10:35a @ 12.24" <br />_ -0.01 change = < 0.10gph = Pass <br />TFUD01: 10:52a @ 12.50" to 11:14a @ 12.50" _ -0.00 change = < 0.10gph =Pass <br />SJEHD on site <br />* Mark here if: <br />❑ Spill containers do not have a minimum capacity of five gallons and require replacement. <br />Additional copies of this page may be attached. <br />Page 2 of 2 <br />