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UNDERGROUND STORAGE TANK SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of s) V. TANK SECONDARY CONTAINMENT INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer Modern Weldinq A El I B El 11C z D A ❑ I B 1 C ❑ I D Test Method Used: ❑Manufacturer Guidelines(Specify): ❑p Industry Code or Engineering Standard(Specify): PEI/RP1200-17/Glass/Steel Tank/-10" Hg. 1 Hour ❑Engineered Method(Specify): Attach the testing procedures and all documentation required to determine the results. #of Attached Pages2 Tank Containment Testing Training and Certifications(List applicable certifications.) Expiration Date ICC Service Technician #5246802-UT 3/21/2021 Underground Storage Tank Tester License #90-1120 12/31/2022 VI. COMMENTS Provide any additional comments here. Tank A is a 1 OK Double Wall Glass Steel, designated for Regular 87 Octane Gasoline. Tank B&Tank C is a 10K Two Compartment, Double Wall Glass Steel with a Single Tank Secondary. Tank B is 5K, designated for Super 91 Octane Gasoline and Tank C is a 5K, designated for Diesel. VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer Ameron A ❑x I B x❑ I C ❑x D ❑ A ❑ I B ❑ I C ❑ I D ❑ Test Method Used: ❑Manufacturer Guidelines(Specify): ❑p Industry Code or Engineering Standard(Specify): PEI/RP1200-17/Fiberglass Pipe/5 Psi 1 hour ❑Engineered Method(Specify): #of Attached Pages Attach the testing procedures and all documentation required to determine the results. 2 Product Piping Containment Testing Training and Certifications(List applicable certifications.) Expiration Date ICC Service Technician #5246802-UT 3/21/2021 Underground Storage Tank Test License#90-1120 12/31/2022 Interstitial Communication Verification Method Used: Release pressure at end of piping runs at UDC's where applicable. VIII. COMMENTS Provide any additional comments here. ID=Identification