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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 l✓J Hydrostatic <br />Tank ID 87 OCTANE 87 OCTANE 91 OCTANE DIESEL # 2 <br />Spill Container Manufacturer: O P W O P W O P W O P W <br />❑✓ Nonmetallic O Nonmetallic O Nonmetallic ❑✓ Nonmetallic <br />Method of Cathodic Protection ❑ Other ❑ Other ❑ Other ❑ Other <br />Is the spill container minimum p Yes ❑✓ Yes ❑✓ Yes O Yes <br />capacity five gallons excluding ❑ No* ❑ No* ❑ No* ❑ No* <br />riser volume? <br />p Drain [Z) Drain ❑✓ Drain ❑✓ Drain <br />Method to keep spill container ❑ pump ❑ Pump ❑ Pump ❑ Pump <br />empty ❑ Other ❑ Other ❑ Other ❑ Other <br />Spill Container Test Results 121 Pass ❑✓ Pass O Pass 171 Pass <br />❑ Fail ❑ Fail I ❑ Fail ❑ Fail <br />Tank ID <br />Spill Container Manufacturer: <br />Method of Cathodic Protection ❑ Nonmetallic El Nonmetallic El Nonmetallic El Nonmetallic <br />❑ 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 ❑ Other ❑ Other ❑ Other ❑ Other <br />❑ Pass ❑ Pass ❑ Pass ❑ Pass <br />Spill Container Test Results ❑ Fail ❑ Fail ❑ 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 />