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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 6 of 6) <br /> XXI. UNDER-DISPENSER CONTAINMENT TESTING INFORMATION <br /> Manufacturers IdentifyUDC ID from Section III for each Manufacturer <br /> N/A 1 n 1 2 F-1 1 3 F14 I-1 I 5 ❑ 1 6 I-1 <br /> _ 7 u 8 _9 Q — 10 11 El 12 _ <br /> 1 2 ❑ 3 ❑ 4 ❑ 5 6 El- <br /> 7 <br /> 7 ❑ 8 ❑ 1 9 ❑ l 10 ❑ 1 11 El 1 12 ❑ <br /> Test Method Used: ❑x Manufacturer Guidelines(Specify): <br /> Hydrostatic Franklin FuelingINCON TS-STS <br /> F-1 In <br /> .y Codc or"yid ng Standard <br /> ❑Engineered Method(Specify): <br /> #of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. 2 <br /> UDC Testing Training and Certifications(List applicable certifications.) Expiration Date <br /> Franklin Fueling INCON TS-STS- 1032363709 09/29/2019 <br /> XXII. COMMENTS <br /> Provide any additional comments here. <br /> Diesel Dispenser- <br /> 11:20am to 11:35am,4.9408"/4.9403"-0.0005 Difference-PASSED <br /> 11:35am to 11:50am,4.9403"/4.9402"-0.0001 Difference-PASSED <br /> If the facility has more components than this form accommodates,additional copies of these pages may be attached. <br /> UDC=Under-Dispenser Containment;ID=Identification <br />