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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of s) <br /> V. TANK SECONDARY CONTAINMENT INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Owens Cornina A D B D I C D I D ❑ <br /> A❑ B 1 C 1 D ❑ <br /> Test Method Used: ❑Manufacturer Guidelines(Specify): <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 /> Tank A is a 12K Double Wall Fiberglass designated for Super 91 Octane Gasoline. <br /> Tank B is a 12K Double Wall Fiberglass designated for Regular 87 Octane Gasoline. <br /> Tank C is a 12K Double Wall Fiberglass designated for Diesel. <br /> NA-Section III-Tanks A, B, & C have Brine Filled Tank Secondary Containment and are Exempt from periodic testing. <br /> VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Smith FRP A 0 B Q I C 0 D ❑ <br /> A❑ B ❑ I C ❑ I D <br /> Test Method Used: 0 Manufacturer Guidelines(Specify): *Bravo Systems Coated Steel UDC's. 3 Psi-1 Hour <br /> ❑ Industry Code or Engineering Standard(Specify): <br /> ❑Engineered Method(Specify): <br /> #of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. 2 <br /> Product Piping Containment Testing Training and Certifications(List applicable certifications.) Expiration Date <br /> ICC Service Technician #5246802-UT 3/20/2021 <br /> Under round Storac <br /> je Tank Tester License #90-1120 12/31/2019 <br /> Interstitial Communication Verification Method Used: <br /> NA-Section III-Sealed System at Termination end of Piping Runs at Bravo System Coated Steel UDC's. <br /> VIII. COMMENTS <br /> Provide any additional comments here. <br /> *Section VII-See Test Procedure Attachment for Product Piping Test Pressure, Time and Protocol, for Fiberglass Piping <br /> Systems that terminate at Bravo System Coated Steel UDC's. <br /> ID=Identification <br />