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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 /> Bravo 1 X 2 3 ❑ 4 ❑ 5 El6 El <br /> 7 ❑ 8 ❑ 9 ❑ 10 ❑ 1 11 ❑ 1 12 ❑ <br /> 1 ❑ 2 ❑ 1 3 ❑ 4 ❑ 1 5 ❑ 6 ❑ <br /> 7 ❑ 1 8 ❑ 1 9 ❑ 1 10 ❑ 1 11 ❑ 1 12 ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify) : <br /> ❑ Industry Code or Engineering Standard (Specify): <br /> Engineered Method (Specify): InCon TS -STS sump test system <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> UDC Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> Franklin Fueling Systems level 4 # 1003213709 2/22/2021 <br /> XXII . COMMENTS <br /> Provide any additional comments here, <br /> i <br /> i <br /> I <br /> I <br /> I <br /> E <br /> E <br /> i <br /> E <br /> t <br /> 4 <br /> If the facility has more components than this form accommodates, additional copies of these pages may be attached. <br /> r <br /> I <br /> 1 <br /> UDC = Under-Dispenser Containment; ID = Identification <br />