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UNDERGROUNDSTORAGETANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of s) <br /> V. TANK SECONDARY CONTAINMENT INFORMATION <br /> Manufacturer Identif Tank ID from Section III for each Manufacturer <br /> Modern Welding I A x❑ 1 B ❑ I C ❑ D ❑ <br /> A I B ❑ I C ❑ I D ❑ <br /> Test Method Used: ❑ Manufacturer Guidelines(Specify): <br /> Vacuum <br /> ❑x Industry Code or Engineering Standard (Specify): PEI RP1200 <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 /> VI. COMMENTS <br /> Provide any additional comments here. <br /> UG010U001 Annular- <br /> -10"HG for one hour, 9:OOam to 10:00am - PASSED <br /> VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Western Fiberglass A ❑x B ❑ C ❑ I D ❑ <br /> A I B ❑ I C ❑ I D ❑ <br /> Test Method Used: ❑ Manufacturer Guidelines(Specify): <br /> Pressure <br /> ❑x Industry Code or Engineering Standard (Specify): PEI RP1200 <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 /> Interstitial Communication Verification Method Used: <br /> N/A <br /> VIII. COMMENTS <br /> Provide any additional comments here. <br /> UG010U001 Supply- <br /> 5 PSI for one Hour, 9:OOam to 10:00am - PASSED <br /> UG010U001 Return- <br /> 5 PSI for one Hour, 9:OOam to 10:OOam -PASSED <br /> ID=Identification <br />