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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 6. SPILL CONTAINER DETAILS <br /> Test Method Developed by ❑ Manufacturer Z Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure A Vacuum ❑ Hydrostatic <br /> Tank ID REG. PREM. DSL <br /> Spill Container Manufacturer: OPw OPw OPw <br /> Method of Cathodic Protection R11 Nonmetallic R) Nonmetallic i R) Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other D Other ❑ Other <br /> Is the spill container minimum 0 Yes 0 Yes 0 Yes Ll Yes <br /> capacity five gallons excluding Q No* ❑ No* ❑ No* ❑ No* <br /> riser volume? <br /> V Drain 0 Drain R1 Drain ❑ Drain <br /> Method to keep spill container g Pump ❑ Pump ❑ Pump ❑ Pump <br /> empty L Other ❑ Other ❑ Other ❑ Other <br /> Pass ® Pass ❑✓ Pass LJPass <br /> Spill Container Test Results Q Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> Nonmetallic Ll Nonmetallic 11 Nonmetallic Ll Nonmetallic <br /> Method of Cathodic Protection E. Other ❑ Other ll 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 Ll pump ❑ Pump ❑ Pump D Pump <br /> empty ED Other ❑ Other ❑ Other LJ Othef <br /> Spill Container Test Results Pass L) Pass E) Pass ❑ Pass <br /> Q Fail Q Fail 0 Fail ❑ Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other," "No,""or"Fail"and each proposed remedy. <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 />