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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 <br /> Test Type ❑ Pressure ® Vacuum ❑ Hydrostatic <br /> Test Equipment Used: 0 to 30" hg. glycerin filled vacuum guage <br /> Tank ID T1 Diesel <br /> Tank Manufacturer JOOR <br /> Tank Capacity 6000 <br /> Test Start Time 11:45 <br /> Initial Reading 10 <br /> Test End Time 12:45 <br /> Final Reading 10 <br /> Change in Reading 0 <br /> Pass/Fail Criteria 0 <br /> Tightness Test Results ® Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional <br /> Test Type ® Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: 0 to 15 psi glycerin filled pressure guages <br /> Pipe Run ID Supply/Return 1 Supp /Return 2 Supply Vent <br /> Pipe Manufacturer Total containment Total containment Total containment A.O. SMITH <br /> Test Start Time 11:30 11:30 11:30 11:30 <br /> Initial Reading 5 5 5 5 <br /> Test End Time 12:30 12:30 12:30 12:30 <br /> Final Reading 5 5 5 5 <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 <br /> Pipe Manufacturer <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 I ❑ 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 2 of 7 <br />