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Underground Storage Tank <br />Spill Containment Testing Report Farm <br />6. SPILL CONTAINMENT DETAILS <br />Test Method Developed by ❑ <br />Manufacturer D Industry Standard ❑ Professional Engineer <br />TestType ❑ <br />Pressure 0 Vacuum <br />A Hydrostatic <br />❑ Check this box if Appendix 6.1 continuation page is attached. <br />Tank ID <br />T1:SUPREME <br />T2:REGULAR <br />DSL <br />Spill Containment Manufacturer: <br />opw <br />opw <br />opw <br />Method of Cathodic Protection <br />&?I Nonmetallic <br />Z Nonmetallic <br />21 Nonmetallic <br />❑ Nonmetallic <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />Is the spill containment <br />0 Yes <br />V Yes <br />V Yes <br />❑ Yes <br />minimum capacity five gallons <br />excludingriser volume? <br />[I N°* <br />El No* <br />21 Drain <br />El N°* <br />0 Drain T <br />El N°* <br />❑ Drain <br />Method to keep spill <br />21 Drain <br />containment empty <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />Spill Containment Test Results✓❑ <br />Pass <br />Z Pass <br />[l✓ Pass <br />❑ Pass <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />Tank ID <br />Spill Containment Manufacturer: <br />Method of Cathodic Protection <br />❑ Nonmetallic <br />❑ Nonmetallic <br />❑ Nonmetallic <br />❑ Nonmetallic <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />Is the spill containment <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />minimum capacity five gallons <br />El No* <br />U No* <br />U No* <br />El No* <br />excluding riser volume? <br />❑ Drain <br />❑ Drain <br />❑ Drain <br />Method to keep spill <br />❑ Drain <br />containment empty <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />Spill Containment Test Results <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />7. COMMENTS <br />❑ Check this box if any spill containment has less than 5 gallons capacity and requires <br />replacement. <br />Describe all answers marked "Other. " "No. or "Fait" and each proposed remedy in Section T. <br />Page 2 of 2 <br />