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UNDERGROUNDSTORAGETANK SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of s) V. TANK SECONDARY CONTAINMENT INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer Modern Weld in /Jacketed Doubl A p I B El I C z I D ❑ A ❑ I B ❑ I C I D❑ Test Method Used: ❑Manufacturer Guidelines(Specify): ❑x Industry Code or Engineering Standard(Specify): PEI/RP900/Steel Tank/-6" Hg. 1 Hour ❑Engineered Method(Specify): Attach the testing procedures and all documentation required to determine the results. #of Attached Pages Tank Containment Testing Training and Certifications(List applicable certifications.) Expiration Date VI. COMMENTS Provide any additional comments here. VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer Ameron LCX FRP A ❑x I B ❑x C 0 DE]A ❑ B ❑ 1 C ❑ I D ❑ Test Method Used: ❑Manufacturer Guidelines(Specify): ❑x Industry Code or Engineering Standard(Specify): PEI/RP900/Fiberglass Pipe/5 Psi 1 hour ❑Engineered Method(Specify): #of Attached Pages Attach the testing procedures and all documentation required to determine the results. Product Piping Containment Testing Training and Certifications(List applicable certifications.) Expiration Date Interstitial Communication Verification Method Used: Release pressure at end of Piping Run by loosing clamp on Test/Seal off Boots at UDC's when applicable. VIII. COMMENTS Provide any additional comments here. It is not alway possible to verify Test Pressure continuity when Test/Seal Off Boots at UDC's cannot be reached to loosen clamps. Some UDC's have bottom Penetrations for the Piping and have no access to the Secondary portion of the Piping to allow verification of continuity without breeching the integrity of the sealed system at the UDC end of the Piping Run. ID=Identification