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a <br /> CERTIFICATE OF COMPLETION <br /> A <br /> Interstitial V ccum Test ([VT) <br /> For The <br /> PLASTEEL® Double-Wall Underground Tank <br /> I. Third Party Evaluation: This leak tightness Installation Location: <br /> test method has been third party evaluated per the <br /> Alternate EPA Test Protocols for Plasteel Inc. The <br /> third party environmental consulting firm that per- <br /> formed the evaluation was: <br /> Ken Wilcox Associates, Inc. <br /> 7M 19401 E. 40 Highway, Suite 100IV. Test Results. The interstitial vacuum test was <br /> Independence, MO 64055 <br /> (816) 795-7997 performed per Appendix B. The following data was <br /> recorded: <br /> A copy of the evaluation is on file at each authoriz- Nominal Tank Capacity: <br /> ed PLASTEEL19 tank manufacturer and at: (Gallons) <br /> Plasteel Inc. Primary Tank Product: <br /> 1189 In <br /> Ave. (air, gasoline, diesel, water) <br /> Escondido, CA 92029 Required Test Period: 7,_ <br /> (619)745-0333 (Hours, per Appendix B, Figure 6.0) <br /> 11. Tank OescriPtion: Initial Gauge Reading: _inches Hg. FIG-1 <br /> r2l J Date Time am/pm <br /> Capacity: Gallons Final Gauge Reading: inches Hg. <br /> Date _ Time ampm <br /> Jacketed: Total Elapsed Time Period: Rio <br /> Composite: (Hours) <br /> Compartmented: Yes No Pass Fail (Initial) <br /> V. Statement of Test. I certify that the r,,, <br /> 1%iI 1 <br /> U.L. Number PLASTEELO Double-wall tank described above has <br /> %�1K91 <br /> been tested leak tight per Appendix B of the <br /> PLAMELO Tank Installation Instructions. "!'r <br /> Tank Manufacturer: Testing Company: <br /> Name: Name: <br /> Address: Address: <br /> Ill. installation'Information: Telephone: <br /> Tank Owner: <br /> Signature <br /> I Name: Printed Name <br /> Addrass: A,. <br /> Title <br /> 9?0 Date <br /> lVT-CERT 694 <br /> W4 MMM.11'� I <br /> IMMM IC Ji Ji MMMMEMMMMI <br />