Laserfiche WebLink
UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM ( Page 5 of 5) <br /> XVII . FILL RISER SUMP TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Unknown Fiberglass Ax❑ B ❑x C ❑x D ❑ <br /> A ❑ e ❑ 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 /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. 2 <br /> Fill Riser Sump Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> Caldwell Level Change Indicator 7/5/2020 <br /> ICC UST Service Technician #5246802- UT 3/20/2021 <br /> Underground Storage Tank Tester License #90- 1120 12/31 /2019 <br /> XVIII , COMMENTS <br /> Provide any additional comments here. <br /> XIX. VENT / TRANSITION SUMP TESTING INFORMATION <br /> Manufacturer Identify Vent / Transition Sump ID from Section III for each Manufacturer <br /> a ❑ Ib ❑ Ic ❑ d ❑ <br /> a ❑ I b ❑ I c ❑ I 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 / Transition Sump Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> XX. COMMENTS <br /> Provide any additional comments here. <br /> NA-Section llkNo Vent/Transition Sump present at this UST Facility . <br /> ID = Identification <br />