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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 ❑ Industry Standard ❑ Professional Engineer <br /> Test Type ❑ Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: NIA <br /> ❑ Check this box if Appendix 8.1 continuation page is attached. <br /> Tank ID <br /> Tank 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 ❑Pass❑ Fail ❑Pass❑Fail ❑ Pass❑ Fail <br /> 7. PIPE SECONDARY CONTAINMENT TEST <br /> Test Method Developed by ❑ Manufacturer 0 Industry Standard ❑ Professional Engineer <br /> Test Type 21 Pressure ❑ Vacuum ❑ Hydrostatic <br /> Test Equipment Used: 0 10 Psi Gauge <br /> ❑ Check this box if Appendix 8.2 continuation page is attached. <br /> Pipe Run ID 91 <br /> Pipe Manufacturer Smith <br /> Test Start Time 8:00 am <br /> Initial Reading 3 psi <br /> Test End Time 9:00 am <br /> Final Reading 3 psi <br /> Change in Reading 0 <br /> Pass/Fail Criteria 0 <br /> Tightness Test Results ❑✓ Pass❑Fail ❑Pass❑ Fail ❑Pass❑Fail ❑Pass❑ Fail <br /> Continuity Test Results ❑✓ Pass ❑Fail ❑Pass❑ Fail ❑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 ❑ Pass❑ Fail ❑Pass ❑Fail ❑Pass❑Fail <br /> Continuity Test Results ❑Pass ❑Fail ❑Pass❑Fail ❑Pass ❑Fail ❑Pass ❑Fail <br /> Describe in Section 9 all tests marked "Fail"and any repairs made during the test. Page 2 of 4 <br />