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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 /> Manufacturers Identify UDC ID from Section III for each Manufacturer <br /> Western Fiberglass 1 0 2 X 3 0 4 Q 5 6 x❑ <br /> 7 ❑x 8 x❑ 9 ❑ 10 ❑ 11 ❑ 1 12 ❑ <br /> 1 ❑ 2 ❑ 3 ❑ 4 ❑ 1 5 ❑ 1 6 ❑ <br /> 7 ❑ 8 ❑ 9 ❑ 10 ❑ I 11 ❑ 1 12 ❑ <br /> Test Method Used: ❑x Manufacturer Guidelines(Specify): <br /> Franklin Fueling Sump Testing System <br /> ❑ Industry Code or Engineering Standard(Specify): <br /> ❑ Engineered Method(Specify): <br /> Attach the testing procedures and all documentation required to determine the results. #of Attached Pages8 <br /> UDC Testing Training and Certifications(List applicable certifications.) Expiration Date <br /> Franklin Fueling Systems Containment Testing 8/28/2020 <br /> XXII. COMMENTS <br /> Provide any additional comments here. <br /> UDC 11-12 initially failed testing, minor adjustment to Bravo entry fitting was done to obtain passing result <br /> If the facility has more components than this form accommodates,additional copies of these pages may be attached. <br /> RFU" E1Vr" rm` <br /> JUN 10 2020 <br /> ENVIRONMENTAL HEALTH <br /> DEPARTMENT <br /> UDC=Under-Dispenser Containment;ID=Identification <br />