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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 0 Industry Standard ❑ Professional <br /> Test Type ❑ Pressure 0 Vacuum ❑ Hydrostatic <br /> Test Equipment Used: 0 to 30 in Hg glycerin filled vacuum gauge(s) <br /> Tank ID T1 Diesel <br /> Tank Manufacturer Owens Corning <br /> Tank Capacity 4000 <br /> Test Start Time 14:30 <br /> Initial Reading 10 <br /> Test End Time 15:30 <br /> Final Reading 10 <br /> Change in Reading 0 <br /> Pass/Fail Criteria 0 <br /> Tightness Test Results 0 Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional <br /> Test Type 0 Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: 0 to 15 psi glyceride filled pressure gauge(s) <br /> Pipe Run ID Supply 1 Supply 2 Return <br /> Pipe Manufacturer A.O. SMITH A. O. Smith A. O. Smith <br /> Test Start Time 14:20 14:20 14:20 <br /> Initial Reading 5 5 5 <br /> Test End Time 15:20 15:20 15:20 <br /> Final Reading 5 5 5 <br /> Change in Reading 0 0 0 <br /> Pass/Fail Criteria 0 0 0 <br /> Tightness Test Results 0 Pass ❑ Fail 0 Pass ❑ Fail 0 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 ❑ Pass ❑ Fail I ❑ Pass ❑ Fail I ❑ Pass ❑ Fail 1 ❑ 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 />