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Underground Storage Tank Secondary Containment Testing Report Form 6. TANK SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer N Industry Standard ❑ Professional Engineer Test Type ❑ Pressure N Vacuum ❑ Hydrostatic Test Equipment Used: Vacuum Gauge Tank ID Tank Manufacturer Tank Capacity Test Start Time Initial Reading Test End Time Final Reading Change in Reading Pass/Fail Criteria 11 Tightness Test Results ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail 7. PIPE SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer N Industry Standard ❑ Professional Engineer Test Type N Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used: Pressure Gauge Pipe Run ID 87 Product 87 Vent 91 Product 91 Vent Pipe Manufacturer Ameron Ameron Ameron Ameron Test Start Time 10:10 AM 10:10 AM 10:17 AM 10:15 AM Initial Reading 5 PSI 5 PSI 5 PSI 5 PSI Test End Time 11:10 AM 11:10 AM 11:17 AM 11:15 AM Final Reading 0 PSI 5 PSI 5 PSI 5 PSI Change in Reading 5 PSI 0 PSI 0 PSI 0 PSI Pass/Fail Criteria 0 PSI 0 PSI 0 PSI 0 PSI Tightness Test Results ❑ Pass N Fail N Pass ❑ Fail N Pass ❑ Fail N Pass ❑ Fail Pipe Run ID Vapor Return DSL Product Diesel Vent Pipe Manufacturer Ameron Ameron Ameron Test Start Time 10:16 AM 10:22 AM 10:20 AM Initial Reading 5 PSI 5 PSI 5 PSI Test End Time 11:16 AM 11:22 AM 11:20 AM Final Reading 5 PSI 5 PSI 5 PSI Change in Reading 0 PSI 0 PSI 0 PSI Pass/Fail Criteria 0 PSI 0 PSI 0 PSI Tightness Test Results N Pass ❑ Fail 1 N Pass ❑ Fail N Pass ❑ Fail 1 ❑ Pass ❑ Fail Additional copies of this page may be attached. All tests marked "Fail'and any repairs made before or during the tightness test must be described in the COMMENTS section. Page 2 of 5