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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 frorn Section III for each Manufacturer <br /> Modern welding A © 1 B © C ✓❑ D <br /> A ❑ B ❑ C ❑ I D <br /> Test Method Used: ❑Manufacturer Guidelines (Specify): <br /> ® Industry Code or Engineering Standard (Specify): Vacuum <br /> ❑ Engineered Method (Specify): <br /> #of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> Tank Containment Testing Training and Certifications(List applicable certifications.) Expiration Date <br /> ICC UST Certification#8819839 10/15/2021 <br /> VI. COMMENTS <br /> Provide any additional comments here. <br /> Started 87 annular at 8:30 am at 7 hg test ended at 9:30 am at 7 hg. <br /> Started 89 annular at 8:45 am at 7 hg test ended at 9:45 am at 7 hg. <br /> Started Diesel/91 annular at 9:00 am at 7 hg test ended at 10:00 am at 7 hg. <br /> No Inspector on site. <br /> VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Environ A © B Z C W1 D 0 <br /> A ❑ B ❑ C ❑ 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 10/25/2019 <br /> Interstitial Communication Verification Method Used: <br /> VIII. COMMENTS <br /> Provide any additional comments here. <br /> 87, 89, 91 product lines unable to pressurize due to torn test boots in UDC's 1/2, 3/4, 5/6 <br /> Diesel product started at 11:00 am at 5 psi test ended at 12:00 pm at 5 psi <br /> ID=Identification <br />