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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 IB x❑ 1 C 0 D ❑ A ❑ I B ❑ I C ❑ I D ❑ Test Method Used: ❑Manufacturer Guidelines(Specify): ❑p Industry Code or Engineering Standard(Specify): PEI/RP 1200-17/Fiberglass Tank/-10" Hg. 1 hr. ❑ 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 Under round Storage Tank Testing License #90-1120 12/31/2022 VI. COMMENTS Provide any additional comments here. Tank A is a 12K Double Wall Fiberglass, designated for Regular 87 Octane Gasoline. Tank B is a 12K Double Wall Fiberglass, designated for Diesel. Tank C is a 12K Double Wall Fiberglass, designated for Super 91 Octane Gasoline. VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer Smith FRP AN I BN I C ❑x D ❑ A ❑ B ❑ I C I D ❑ Test Method Used: ❑Manufacturer Guidelines(Specify): ❑p Industry Code or Engineering Standard(Specify): PEI/RP 1200-17/Fiberglass Pipe/5 PSI 1 hr. ❑Engineered Method(Specify): Attach the testing procedures and all documentation required to determine the results. #of Attached Pages2 Product Piping Containment Testing Training and Certifications(List applicable certifications.) Expiration Date ICC Service Technician #5246802-UT 3/21/2021 Under round 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