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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of 6) <br /> V. TANK SECONDARY CONTAINMENT INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Modern Welding A 0 B x❑ IC ❑x D ❑ <br /> A ❑ B ❑ I C ❑ I D ❑ <br /> Test Method Used: ❑ Manufacturer Guidelines(Specify): <br /> ❑X Industry Code or Engineering Standard (Specify): PEI/RP1200-17/Glass/Steel Tank/-10" Hg. 1 Hour <br /> ❑Engineered Method (Specify): <br /> Attach the testing procedures and all documentation required to determine the results. #of Attached Pages2 <br /> Tank Containment Testing Training and Certifications(List applicable certifications.) Expiration Date <br /> ICC Service Technician #5246802-UT 4/3/2019 <br /> Underground Storage Tank Tester License #90-1120 12/31/2019 <br /> VI. COMMENTS <br /> Provide any additional comments here. <br /> Tank#B&C is a 12K Double Compartment, Single Tank Secondary. 6K 91 &6K Diesel. <br /> Tank#A is a 12K 87. <br /> VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Smith Fibercast FRP A x❑ I B x❑ I C 0 D ❑ <br /> A ❑ 1 B ❑ I C ❑ I D ❑ <br /> Test Method Used: ❑Manufacturer Guidelines(Specify): <br /> ❑x Industry Code or Engineering Standard(Specify): PEI/RP1200-17/Fiberglass Pipe/5 Psi 1 hour <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 4/3/2019 <br /> Underground Storage Tank Test License #90-1120 12/31/2019 <br /> Interstitial Communication Verification Method Used: <br /> NA-Sealed System at end of Piping Runs at Bravo System UDC's. <br /> VIII. COMMENTS <br /> Provide any additional comments here. <br /> ID=Identification <br />