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Underground Storage Tank Secondary Containment Testing Report Form 6. TANK SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer Test Type ❑ Pressure ® Vacuum ❑ Hydrostatic Test Equipment Used: Vacuum Pump/Vacuum Gauge in Hg. Tank ID 1-87/91/Dsl Tank Manufacturer Modern Wld Tank Capacity 22K 3 Compt Test Start Time 8:40 Initial Reading -10" Hg. Test End Time 10:40 Final Reading -10" Hg. Change in Reading 0" Hg. Pass/Fail Criteria No Loss Tightness Test Results ® Pass ❑ Fail I ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail 7. PIPE SECONDARY CONTAINMENT TEST Test Method Developed by ❑ Manufacturer ® Industry Standard ❑ Professional Engineer Test Type ❑x Pressure ❑ Vacuum ❑ Hydrostatic Test Equipment Used: Pressure Gauges in Psi/Nitrogen Pipe Run ID 1-87-Product 2-87-Vent 3-Gas Vapor 4-91-Product Pipe Manufacturer Ameron Ameron Ameron Ameron Test Start Time 8:30 8:30 8:30 8:35 Initial Reading 5 Psi 5 Psi 5 Psi 5 Psi Test End Time 9:30 9:30 9:30 9:35 Final Reading 5 Psi 5 Psi 5 Psi 5 Psi Change in Reading 0 Psi 0 Psi 0 Psi 0 Psi Pass/Fail Criteria No Loss No Loss No Loss No Loss Tightness Test Results ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail Pipe Run ID 5-91 Vent 6-Dsl-Prod 7-Dsl-Vent Pipe Manufacturer Ameron Ameron Ameron Test Start Time 8:35 8:40 8:40 Initial Reading 5 Psi 5 Psi 5 Psi Test End Time 9:35 9:40 9:40 Final Reading 5 Psi 5 Psi 5 Psi Change in Reading 0 Psi 0 Psi 0 Psi Pass/Fail Criteria No Loss No Loss No Loss Tightness Test Results ® Pass ❑ Fail ® Pass ❑ Fail ® Pass ❑ Fail ❑ 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