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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum ® Hydrostatic <br /> Tank ID T-1/ Diesel <br /> Spill Container Manufacturer: PhilTite <br /> Method of Cathodic Protection ® Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ® Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding Ei No* ❑ No* ❑ No* ❑ No* <br /> riser volume? <br /> ® Drain ❑ Drain ❑ Drain ❑ Drain <br /> Method to keep spill container ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> empty <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ® Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> Method of Cathodic Protection ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* ❑ No* ❑ No* ❑ No* <br /> riser volume? <br /> ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> Method to keep spill container ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> empty <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other," 'Wo,"or "Fail"and each proposed remedy. <br /> Other Cathodic Protection Comments: Other Method Comments: 11 Failure <br /> Explanations: 11 Additional Comments: <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 16 of 17 <br />