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UNDERGROUND STORAGE TANK SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of 6) V. TANK SECONDARY CONTAINMENT INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer Modern Welding Ax❑ B x❑ C Q D ❑ A ❑ B ❑ I C ❑ I D ❑ Test Method Used : ❑ Manufacturer Guidelines (Specify) : ❑p Industry Code or Engineering Standard (Specify) : PEI / RP1200- 17/Glass/Steel Tank/- 10 " Hg . 1 Hour ❑ Engineered Method (Specify): # of Attached Pages Attach the testing procedures and all documentation required to determine the results. 2 Tank Containment Testing Training and Certifications (List applicable certifications.) Expiration Date ICC Service Technician #524680MT 4/3/2019 Underground Storage Tank Tester License #90 - 1120 12/31 /2019 VI . COMMENTS Provide any additional comments here. Tank # B &C is a 12K Double Compartment, Single Tank Secondary . 6K 91 & 6K Diesel . Tank #A is a 12K 87 . VII . PRODUCT PIPING CONTAINMENT TESTING INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer Smith Fibercast FRP AX I BN C X D ❑ A ❑ I B ❑ I C ❑ I D ❑ Test Method Used : ❑ Manufacturer Guidelines (Specify) : ❑x Industry Code or Engineering Standard (Specify) : PEI / RP1200 - 17/Fiberglass Pipe/5 Psi 1 hour ❑ Engineered Method (Specify): # of Attached Pages Attach the testing procedures and all documentation required to determine the results. 2 Product Piping Containment Testing Training and Certifications (List applicable certifications) Expiration Date ICC Service Technician #5246802- UT 4/3/2019 Underground Storage Tank Test License #90 - 1120 12/31 /2019 i Interstitial Communication Verification Method Used : NA- Sealed System at end of Piping Runs at Bravo System UDC' s . VIII . COMMENTS Provide any additional comments here. Il 11 ID = Identification e