Laserfiche WebLink
Underground Storage Tank <br />Spill Container Testing Report Form <br />6. SPILL CONTAINER DETAILS <br />Test Method Developed by Q <br />Manufacturer ® Industry Standard <br />[I <br />Professional Engineer <br />Test Type ® <br />Pressure ® Vacuum <br />® <br />Hydrostatic <br />Tank ID <br />882-TFUD01 <br />Spill Container Manufacturer: <br />OPW <br />Method of Cathodic Protection <br />® Nonmetallic <br />® Nonmetallic <br />® <br />Nonmetallic <br />p <br />Nonmetallic <br />® Other <br />gj Other <br />Irl <br />Other <br />® <br />Other <br />Is the spill container minimum <br />El Yes <br />@] Yes <br />® <br />Yes <br />1171 <br />Yes <br />capacity five gallons excluding <br />® No* <br />r] No* <br />® <br />No* <br />® <br />No* <br />riser volume? <br />Method to keep spill container <br />® Drain <br />® Drain <br />0 <br />Drain <br />® <br />Drain <br />® Pump <br />® Pump <br />® <br />Pump <br />® <br />Pump <br />empty <br />® Other <br />p Other <br />® <br />Other <br />® <br />Other <br />Spill Container Test Results <br />M Pass <br />IM Pass <br />® <br />Pass <br />® <br />Pass <br />® Fail <br />10 Fail <br />I ® <br />Fail <br />10 <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 />IM <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 />® Drain <br />17 Drain <br />® <br />Drain <br />® <br />Drain <br />Method to keep spill container <br />® Pump <br />® Pump <br />® <br />Pump <br />17 <br />Pump <br />empty <br />® Other <br />0 Other <br />® <br />Other <br />® <br />Other <br />Spill Container Test Results <br />® Pass <br />® Pass <br />® <br />Pass <br />® <br />Pass <br />El Fail <br />[I Fail <br />® <br />Fail <br />117 <br />Fail <br />8. COMMENTS <br />Describe all answers marked "Other," <br />"No, " or "Fail" and each proposed remedy. <br />Using the Caldwell Sump Level Change Indicator from: <br />9:16a @ 14.50" to 9:41 a @ 14.50" _ -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 />