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Underground Storage Tank <br /> Spill Container Testing Report Form <br /> 6. SPILL CONTAINER DETAILS <br /> Test Method Developed by ❑ Manufacturer ❑ Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum ❑ Hydrostatic <br /> Tank ID 87-1 Gasoline 87-2 Gasoline 91 Gasoline Diesel <br /> Spill Container Manufacturer: OPW OPW OPW OPW <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 0 No* 0 No* ❑ No* ❑ No* <br /> riser volume? <br /> Method to keep spill container ❑ Drain © Drain ® Drain ® Drain <br /> empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> [F] Other M Other ❑ Other ❑ Other <br /> Spill Container Test Results C Pass © Pass ® Pass ® Pass <br /> Fail ❑ Fail ❑ Fail 117 Fail <br /> Tank ID <br /> Spill Container Manufacturer: <br /> Method of Cathodic Protection © Nonmetallic [F] Nonmetallic [r] Nonmetallic ❑ Nonmetallic <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* 7 No* © No* ❑ No* <br /> riser volume? <br /> Method to keep spill container ® Drain ❑ Drain ❑ Drain ❑ Drain <br /> empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> 0 Other ® Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass © Pass ❑ Pass <br /> ❑ Fail © Fail 0 Fail © Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other," "No,"or "Fail"and each proposed remedy. <br /> Replaced Swivel on 87-1 Spill Container. <br /> * Mark here if: <br /> 0 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 />