Laserfiche WebLink
Underground Storage Tank <br /> Spill Container Testing Report Form <br /> Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum 0 Hydrostatic <br /> Tank ID T-1/ Diesel <br /> Spill Container Manufacturer: EBw <br /> o Nonmetallic ❑ Nonmetallic ❑ Nonmetallic ❑ Nonmetallic <br /> Method of Cathodic Protection ❑ Other ❑ Other ❑ Other ❑ Other <br /> Is the spill container minimum pp Yes ❑ Yes ❑ Yes ❑ Yes <br /> capacity five gallons excluding ❑ No* ❑ No* ❑ No* ❑ No* <br /> riser volume? <br /> Method to keep spill container o Drain ❑ Drain ❑ Drain ❑ Drain <br /> empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results o Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> Tank ID <br /> Spill Container Manufacturer: <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 Ei No* ❑ No* ❑ No* ❑ No* <br /> riser volume? <br /> Method to keep spill container ❑ Drain ❑ Drain ❑ Drain ❑ Drain <br /> empty ❑ Pump ❑ Pump ❑ Pump ❑ Pump <br /> ❑ Other ❑ Other ❑ Other ❑ Other <br /> Spill Container Test Results ❑ Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8. COMMENTS <br /> Describe all answers marked "Other,"'No,"or "Fail"and each proposed remedy. <br /> Other Cathodic Protection Comments: Other Method Comments: 11 Failure <br /> Explanations: 11 Additional Comments: <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 18 of 19 <br />