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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 /> Manufacturer(s) : Identify UDC ID from section III for each Manufacturer <br /> S . Bravo Systems #1 -2 #34 #5-6 #7-8 #9 -10 #11A2 <br /> Test Method Used : <br /> ❑ Manufacturer Guidelines : (Specify) <br /> ® Industry Code or Engineering Standard : (Specify) RPA200 / Guidelines Adopted by CAL CUPA Forum <br /> ❑ Engineered Method : (Specify) <br /> Attach the testing procedures and all documentation required to determine the results. # of Attached Pages1 <br /> UDC Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> ICC California Service Technician UT Cert. #5254736 11 /03/2020 <br /> S . Bravo Systems Swat & National 12/15/2020 <br /> Franklin Fueling Systems Incon TS -STS Sump Tester Level 4 Cert. #1001773708 02/03/2021 <br /> XXII . COMMENTS <br /> Provide any additional comments here. <br /> If the facility has more components than this form accommodates, additional copies of these pages may be attached. <br /> f <br /> I <br />[ CERS = California Environmental Reporting System, ID = Identification , UST = Underground storage tank, ICC = International Code Council, <br /> NA = Not applicable, UDC = Under-dispenser containment <br />