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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of 6) <br /> V. TANK SECONDARY CONTAINMENT INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> XERXES A ❑x B x❑ I Cx❑ D ❑ <br /> A ❑ B ❑ I C ❑ 1 D ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify) : <br /> ❑x Industry Code or Engineering standard (Specify) : PEI / RP1200 - 17/Fiberglass Tank/- 10 " Hg . 1 Hour <br /> ❑ Engineered Method (Specify): <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. 2 <br /> Tank Containment Testing Training and Certifications (List applicable certifications) Expiration Date <br /> ICC Service Technician #5246802- UT 3/21 /2021 <br /> Underground Storage Tank Tester License #90- 1120 12/31 /2022 <br /> VI . COMMENTS <br /> Provide any additional comments here. <br /> Tank A is a 15K , Double Wall Fiberglass designated for Regular 87 Octane Gasoline . <br /> Tank B is a 15K, Double Wall Fiberglass designated for Regular 87 Octane Gasoline . <br /> Tank C is a 12 K Double Wall Fiberglass designated for Super 91 Octane Gasoline . <br /> VII . PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Smith FRP Ax❑ Bx❑ C D <br /> A ❑ B ❑ C ❑ I D ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify): <br /> ❑x Industry Code or Engineering Standard (Specify): PEI / RP1200 - 17/ Fiberglass Pipe/5 Psi 1 hour <br /> ❑ Engineered Method (Specify): <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. 2 <br /> Product Piping Containment Testing Training and Certifications (List applicable certifications) Expiration Date <br /> ICC Service Technician #5246802- UT 3/21 /2021 <br /> E <br /> Underground Storage Tank Tester License #90- 1120 12/31 /2022 <br /> Interstitial Communication Verification Method Used : <br /> Release pressure at end of Piping Runs at UDC's where applicable . <br /> Villa COMMENTS <br /> Provide any additional comments here. <br /> ID = Idenfdication <br />