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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of s) <br /> V. TANK SECONDARY CONTAINMENT INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Modern Welding A x❑ I B x❑ I Cx❑ D ❑x <br /> Modern Weldin A ❑ I B ❑ C ❑ I D ❑x <br /> Test Method Used: ❑Manufacturer Guidelines(Specify): <br /> ❑p Industry code or Engineering Standard(Specify): PEI/RP1200-17/131ass/Steel Tank/-10" Hg. 2 Hours <br /> ❑Engineered Method (Specify): <br /> #of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. 2 <br /> Tank Containment Testing Training and Certifications(List applicable certifications.) Expiration Date <br /> ICC Service Technician #5246802-UT 3/21/2021 <br /> Under round Storage Tank Tester License #90-1120 12/31/2022 <br /> VI. COMMENTS <br /> Provide any additional comments here. <br /> Tank 1-A is a 20K, Glass/Steel, designated for Diesel <br /> Tank 2-13 is a 20K, Glass/Steel, designated for Diesel <br /> Tank 3-C is a 20 K, Glass/Steel, designated for Regular 87 Octane Gasoline. <br /> Tank 4-D &5-D is a 20K, Double Compartment, Glass/Steel, designated 12K Super 91 Octane Gasoline and 8K Regular <br /> 87 Octane Gasoline. <br /> Note:Section I-Facility Information-Date of Secondary Containment Test-Testing was commenced on 12/18/2019 and <br /> completed on 12/19/2019. <br /> VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Smith FRP A ❑x 1 B x❑ I Cx❑ D ❑x <br /> Smith FRP A ❑ I B ❑ I C ❑ D ❑x <br /> Test Method Used: ❑Manufacturer Guidelines(Specify): <br /> ❑X Industry code or Engineering Standard(Specify): PEI/RP1200-17/Fiberglass Pipe/5 Psi 1 hour <br /> ❑Engineered Method(Specify): <br /> #of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. 2 <br /> Product Piping Containment Testing Training and Certifications(List applicable certifications) Expiration Date <br /> ICC Service Technician #5246802-UT 3/21/2021 <br /> Under round Storage Tank Tester License #90-1120 12/31/2022 <br /> Interstitial Communication Verification Method Used: <br /> Release pressure at end of Piping Runs at UDC's, where applicable. <br /> VIII. COMMENTS <br /> Provide any additional comments here. <br /> ID=Identification <br />