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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of sl <br /> V. TANK SECONDARY CONTAINMENT INFORMATION <br /> Manufacturer entify Tank ID from Section III for each Manufacturer <br /> A ❑ B ❑ I C ❑ D ❑ <br /> A ❑ B ❑ I CE—��D ❑ <br /> Test Method Used: ❑Manufacturer GuidelinesS eci <br /> ( p fY) <br /> ❑Industry Code or Engineering Standard (Specify): <br /> ❑Engineered Method(Specify): <br /> Attach the testing procedures and all documentation required to determine the results. #of Attached Pages <br /> Tank Containment Testing Training and Certifications(List applicable certifications.) Expiration Date <br /> VI. COMMENTS <br /> Provide any additional comments here. <br /> Wet Annulars <br /> No Inspector on site. <br /> VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Ameron A ❑ B ® CD � <br /> A ❑ B ❑ C ❑ I D ❑ <br /> Test Method Used: ❑Manufacturer Guidelines(Specify): <br /> ®Industry Code or Engineering Standard(Specify): Pressure <br /> ❑Engineered Method(Specify): <br /> #of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> Product Piping Containment Testing Training and Certifications(List applicable certifications.) Expiration Date <br /> ICC UST Certification#8819839 10/15/2021 <br /> Interstitial Communication Verification Method Used: <br /> VIII. COMMENTS <br /> Provide any additional comments here. <br /> Started 87 west product at 9:00 am at 5 psi ended at 10:00 am at 5 psi <br /> Started 89 west product at 9:10 am at 5 psi ended at 10:10 am at 5 psi <br /> Started 91 west product at 9:20 am at 5 psi ended at 10:20 am at 5 psi <br /> Started Diesel product at 9:30 am at 5 psi ended at 10:30 am at 5 psi <br /> ID=Identification <br />