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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 /> Modern Welding AM I B xZ C Fx] I D ❑ <br /> A ❑ I B ❑ C ❑ D ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify) : <br /> ❑x Industry Code or Engineering Standard (Specify): PEVRP1200- 17/Steel Tank/- 6 " 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 12K , Double Wall Fiberglass designated for Regular 87 Octane Gasoline . <br /> Tank B is a 12K, Double Wall Fiberglass designated for Regular 87 Octane Gasoline . <br /> Tank C is a 10 K Double Wall Fiberglass designated for Super 91 Octane Gasoline . <br /> NA-Section III -Summery of Secondary Containment Test Results , No Tank D present at this UST Facility. <br /> VII . PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Smith FRP/*See Section VIII Ax❑ B XX C X D ❑ <br /> Smith FRP/*Va or Pot to Tank A A ❑ B ❑ C ❑ D X <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify) : <br /> ❑x Industry Code or Engineering Standard (Specify): <br /> PEI / RP1 200 - 1 7/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 />[' <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 Transition Piping Sump , Vapor Pot Sump , and UDC' s where applicable . <br /> VIII . COMMENTS <br /> Provide any additional comments here. <br /> * Product Piping Containment A, B & C are From Tank A, B & C Turbine/Product Piping Sumps to Transition Piping Sump <br /> to Fuel Island UDC's termination end of Piping Runs . <br /> * Product Piping Containment D is from Vapor Pot to Tank A for Condensed Vapor to Liquid Recovery from Vapor Pot <br /> Tank . <br /> ID = Identification <br />