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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM ( Page 2 of 6) <br /> V. TANK SECONDARY CONTAINMENT INFORMATION <br /> Manufacturer I Identify Tank ID from Section III for each Manufacturer <br /> N/A I A B ❑ C ❑ D ❑ <br /> A ❑ B ❑ 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. 0 <br /> Tank Containment Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> VI . COMMENTS <br /> Provide any additional comments here. <br /> VII . PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> NOV/Smith A x❑ I B ❑ = C ❑ D ❑ <br /> A ❑ I B ❑ I C ❑ I D ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify): <br /> ❑x Industry Code or Engineering Standard (Specify) : PEI 1200 Pressure test @ 5 . 00 PSI for One hour . <br /> ❑ Engineered Method (Specify) : <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. 1 <br /> Product Piping Containment Testing Training and Certifications (List applicable certifications) Expiration Date <br /> Service Tech 8004551 - UT 10/28/2021 <br /> Interstitial Communication Verification Method Used : <br /> At the far end . <br /> VIII . COMMENTS <br /> Provide any additional comments here. <br /> ID = Identification <br />