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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 4 of 6) <br /> XIII. VAPOR RECOVERY PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> A ❑ I B ❑ C ❑ D <br /> A ❑ B ❑ I C ❑ I D ❑ <br /> Test Method Used: p Manufacturer Guidelines(Specify): <br /> ❑ Industry Code or Engineering Standard(Specify): <br /> ❑ Engineered Method (Specify): <br /> #of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> Vapor Recovery Piping Containment Testing Training and Certifications(List applicable certifications.) Expiration Date <br /> Interstitial Communication Verification Method Used: <br /> NA-Section III-No Vapor Recovery Piping Containment at this UST Facility. <br /> XIV. COMMENTS <br /> Provide any additional comments here. <br /> NA-Section III-No Vapor Recovery Piping Containment at this UST Facility. <br /> NA-Section III-No Vapor Recovery Piping or Vapor Recovery Piping Containment for Tank C-Diesel. <br /> XV. TURBINE/PRODUCT PIPING SUMP TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Unknown Fiber lass A ❑X I B ❑X I C 0 D ❑ <br /> A ❑ I B ❑ I C ❑ I D ❑ <br /> Test Method Used: ❑ Manufacturer Guidelines(Specify): <br /> ❑ Industry Code or Engineering Standard (Specify): <br /> Z Engineered Method(Specify): Caldwell Systems/Hydrostatic 30 Minutes <br /> Attach the testing procedures and all documentation required to determine the results. #of Attached Pages2 <br /> Turbine/Product Piping Sump Testing Training and Certifications(List applicable certifications.) Expiration Date <br /> Caldwell Level Change Indicator 6/10/2023 <br /> ICC Service Technician #5246802-UT 3/21/2021 <br /> Underground Storage Tank Tester License #90-1120 12/31/2022 <br /> XVI. COMMENTS <br /> Provide any additional comments here. <br /> ID=Identification <br />