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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM '(Page s of 6) <br /> XVIL FILL RISER SUMP TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> N/A A ZI I B ❑ I C ❑ I D ❑ <br /> A ❑ I B ❑ I C ❑ I D ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify): <br /> Hydrostatic <br /> ❑x Industry Code or Engineering Standard (Specify): PEI RP1200 <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 certifications.) Expiration Date <br /> Franklin Fueling L4 - 1032363709 09-29-2019 <br /> XVIII . COMMENTS <br /> Provide any additional comments here. <br /> UE0420001 Fill Sump - <br /> 9 : 01 am to 9 : 17am , 4 . 5055" START to 4 . 5054" STOP , 0 . 0001 " Difference - PASSED <br /> 9 : 17am to 9 : 32am , 4 . 5055" START to 4. 5055" STOP , 0 . 0000" Difference - PASSED <br /> XIX. VENT / TRANSITION SUMP TESTING INFORMATION <br /> Manufacturer Identify Vent I Transition Sump ID from Section III for each Manufacturer <br /> a ❑ i b ❑ I c ❑ d ❑ <br /> a ❑ I b 1 C 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 /> Vent I Transition Sump Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> XX. COMMENTS <br /> Provide any additional comments here. <br /> ID = Identification <br />