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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 3 of 6) <br /> IX. REMOTE FILL PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> A ❑ B I C ❑ D ❑ <br /> A ❑ 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 /> Remote Fill Piping Containment Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> Interstitial Communication Verification Method Used : <br /> X. COMMENTS <br /> Provide any additional comments here. <br /> N/A <br /> X1 . VENT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Smith A © 1 B © I C ❑ D ❑ <br /> A ❑ I B ❑ I C ❑ I D ❑ <br /> Test Method Used: ❑ Manufacturer Guidelines (Specify): <br /> ® Industry Code or Engineering Standard (Specify): Pressure <br /> ❑ Engineered Method (Specify): <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> Vent Piping Containment Testing Training and Certifications (List applicable certifications) Expiration Date <br /> ICC UST Certification # 8819839 10/25/2019 <br /> Interstitial Communication Verification Method Used : <br /> X11 . COMMENTS <br /> Provide any additional comments here. <br /> Started vent line at 10 : 00 am at 5 psi ended at 11 : 00 am at 5 psi . <br /> ID = Identification <br />