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UNDERGROUND STORAGE TANK SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of 6) V. TANK SECONDARY CONTAINMENT INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer XERXES A El I B x❑ I C z 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 Tank/- 10 " Hg . 1 Hour ❑ Engineered Method (Specify) : # of Attached Pages Attach the testing procedures and all documentation required to determine the results. 2 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 1 12/31 /2022 VI . COMMENTS Provide any additional comments here. Tank A is a 1 OK, Double Wall Fiberglass designated for Supreme 91 Octane Gasoline . Tank B is a 1 OK, Double Wall Fiberglass designated for Regular 87 Octane Gasoline . Tank C is a 10 K Double Wall Fiberglass designated for Regular 87 Octane Gasoline . VII . PRODUCT PIPING CONTAINMENT TESTING INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer Smith FRP A x❑ B x❑ I C ❑x D ❑ A ❑ B ❑ I C ❑ I D ❑ Test Method Used : ❑ Manufacturer Guidelines (Specify): ❑x 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 Tester 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