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UNDERGROUND STORAGE TANK SECONDARY CONTAINMENT TESTING REPORT FORM (Page s of 6) IX. REMOTE FILL PIPING CONTAINMENT TESTING INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer A IB ❑ C ❑ D ❑ A I B ❑ I C ❑ I D ❑ Test Method Used : ❑ Manufacturer Guidelines (Specify) : ❑ Industry Code or Engineering Standard (Specify) : ❑ Engineered Method (Specify) : # of Attached Pages Attach the testing procedures and all documentation required to determine the results. Remote Fill Piping Containment Testing Training and Certifications (List applicable certifications.) Expiration Date Interstitial Communication Verification Method Used : X. COMMENTS Provide any additional comments here. NA-Section llkNo Remote Fill Piping Containment at this UST Facility. XI . VENT PIPING CONTAINMENT TESTING INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer Smith FRP A ❑X B ❑x C ❑x D ❑ A ❑ B ❑ C ❑ D ❑ Test Method Used : ❑ Manufacturer Guidelines (Specify) : G ❑x Industry Code or Engineering Standard (Specify) : PEI / RP1200 - 17/ Fiberglass Pipe/5 Psi 1 Hour I E ❑ Engineered Method (Specify): # of Attached Pages Attach the testing procedures and all documentation required to determine the results. 2 i I Vent Piping Containment Testing Training and Certifications (List applicable certifications.) Expiration Date ICC UST Service Technician #5246802- UT 3/21 /2021 Underground Storage Tank Tester License #90- 1120 12/31 /2022 Interstitial Communication Verification Method Used : Release pressure at end of Piping Runs at Vent Stack . XII . COMMENTS Provide any additional comments here. Note : Replaced Test Boots on Super 91 and Regular 87 at end of Piping Runs at Vent Stack prior to testing . i ID = Identification