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Underground Storage Tank <br />Spill Container Testing Report Form <br />6. SPILL CONTAINER DETAILS <br />Test Method Developed by p Manufacturer ❑ Industry Standard ❑ Professional Engineer <br />Test Type ❑ Pressure ❑Vacuum Q Hydrostatic <br />8. COMMENTS <br />Describe all answers marked "Other," No, or "Fail" and each proposed remedy. <br />* Mark here if: <br />II containers do not have a minimum caaacity of five aallons and reauire replacement. <br />Additional copies of this page maybe attached. <br />Tank ID <br />87 OCTANE <br />91 OCTANE <br />Spill Container Manufacturer: <br />p P W <br />O P W <br />Method of Cathodic Protection <br />El Nonmetallic <br />❑ Nonmetallic <br />M Nonmetallic <br />❑ Nonmetallic <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />Is the spill container minimum <br />p Yes <br />❑ Yes <br />El Yes <br />❑ Yes <br />capacity five gallons excluding <br />❑ No* <br />❑ No* <br />❑ No* <br />❑ No* <br />riser volume? <br />M Drain <br />❑ Drain <br />0 Drain <br />❑ Drain <br />Method to keep spill container <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />empty <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />Spill Container Test Results <br />p Pass <br />❑ Pass <br />p Pass <br />El Pass <br />E] Fail <br />El Fail <br />❑ Fail <br />El Fail <br />Tank ID <br />Spill Container Manufacturer: <br />171 Nonmetallic <br />El Nonmetallic <br />171 Nonmetallic <br />❑ Nonmetallic <br />Method of Cathodic Protection <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />Is the spill container minimum <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />capacity five gallons excluding <br />❑ No* <br />❑ No* <br />❑ No* <br />❑ No* <br />riser volume? <br />El Drain <br />El Drain <br />El Drain <br />El Drain <br />Method to keep spill container <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />❑ Pump <br />empty <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />❑ Pass <br />Spill Container Test Results <br />E] Fail <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />8. COMMENTS <br />Describe all answers marked "Other," No, or "Fail" and each proposed remedy. <br />* Mark here if: <br />II containers do not have a minimum caaacity of five aallons and reauire replacement. <br />Additional copies of this page maybe attached. <br />