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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 3 of 6) <br /> IX. REMOTE FILL PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from section III for each Manufacturer <br /> Test Method Used : <br /> ❑ Manufacturer Guidelines : <br /> (Specify) <br /> ® Industry Code or Engineering Standard : (Specify) RP-1200 / Guidelines Adopted by CAL CUPA Forum <br /> ❑ Engineered Method : <br /> (Specify) <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. None <br /> Remote Fill Piping Containment Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> ICC California Service Technician UT Cert . #8185019 09/10/2021 <br /> Interstitial Communication verification Method Used : Visual drop on gauge by pressure released from furthermost piping runs . <br /> X. COMMENTS <br /> Provide any additional comments here. <br /> Site is not equipped with any remote fill sumps . <br /> XI . VENT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from section III for each Manufacturer <br /> Test Method Used : ❑ Manufacturer Guidelines : <br /> (Specify) <br /> ® Industry Code or Engineering Standard : (Specify) RP-1200 / Guidelines Adopted by CAL CUPA Forum <br /> ❑ Engineered Method : <br /> (Specify) <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> None <br /> Vent Piping Containment Testing Training and Certifications (List applicable certifications) Expiration Date <br /> ICC California Service Technician UT Cert. #8185019 09/10/2021 <br /> Interstitial Communication verification Method Used : Visual drop on gauge by pressure released from furthermost piping runs . <br /> XII . COMMENTS <br /> Provide any additional comments here. <br /> All tank vent lines are single wall NOV A. O . Smith piping . <br /> CERS = California Environmental Reporting System , ID = Identification , UST = Underground storage tank, ICC = International Code Council, <br /> NA = Not applicable, UDC = Under-dispenser containment <br /> F <br /> c <br /> r <br />