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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 6 of 6) <br /> XVII. FILL RISER SUMP TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> A El B C Ej D El <br /> A ❑ B C D Fj <br /> Test Method Used: ❑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 /> Fill Riser Sump Testing Training and Certifications(List applicable certi6ca6ons.) Expiration Date <br /> USEE3 ff/24bl3 A, C10, HAZ 11-3u- U21 <br /> XVIII. COMMENTS <br /> Provide any additional comments here. <br /> This system does not have a fill riser sump. <br /> XIX. VENT/TRANSITION SUMP TESTING INFORMATION <br /> Manufacturer Identify Vent/Transition Sump ID from Section III for each Manufacturer <br /> a ❑ b❑ c ❑ d ❑ <br /> a ❑ b❑ c ❑ d ❑ <br /> Test Method Used: ❑Manufacturer Guidelines(Specify): <br /> ®Industry Code or Engineering Standard(Specify): HE 1 1 2U0 <br /> ❑ Engineered Method(Specify): <br /> #of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> Vent/Transition Sump Testing Training and Certifications(List applicable cerci icadons.) Expiration Date <br /> XX. COMMENTS <br /> Provide any additional comments here. <br /> This system does not have a vent transition sump. <br /> ID=Identification <br /> UN-064 www.unidocs.org 6/6-Rev.06/14/18 <br />