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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page a of 6) <br /> XIII , VAPOR RECOVERY PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer I Identifv Tank ID from Section III for each Manufacturer <br /> A 1 B C ❑ D ❑ <br /> A ❑ I B ❑ C 1 D <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 /> Vapor Recovery Piping Containment Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> Interstitial Communication Verification Method Used : <br /> XIV. COMMENTS <br /> Provide any additional comments here. <br /> No Vapor Recovery Piping Containment at the UST Facility, <br /> XV. TURBINE / PRODUCT PIPING SUMP TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Unknown/Fiberglass Construction A ❑X B ❑x C ❑x D ❑ <br /> A ❑ B ❑ C ❑ I D ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify) : <br /> ❑ Industry Code or Engineering Standard (Specify) : <br /> E Engineered Method (Specify): Caldwell Systems/ Level Change Indicator <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. 2 <br /> Turbine / Product Piping Sump Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> Caldwell Level Change Indicator 7/5/2020 <br /> ICC Service Technician #5246802 - UT 4/3/2019 <br /> Underground Storage Tank Tester License #90- 1120 12/31 /2019 <br /> XVI , COMMENTS <br /> Provide any additional comments here. <br /> t . <br /> ID = Identification <br /> I <br /> i <br /> r <br /> I <br />