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UNDERGROUND STORAGE TANK SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of 6) V. TANK SECONDARY CONTAINMENT INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer XERXES A x❑ I B 0 C 21 D❑ A I B❑ I C❑ D❑ Test Method Used: ❑ Manufacturer Guidelines (Specify): ❑Q Industry Code or Engineering Standard (Specify): PEI/RP1200-17/Fiberglass Tank/-10" Hg. 1 Hour ❑ Engineered Method (Specify): # of Attached Pages Attach the testing procedures and all documentation required to determine the results. 2 Tank Containment Testing Training and Certifications (List applicable certifications.) Expiration Date ICC Service Technician #5246802-UT 3/21/2021 Underground Storage Tank Tester License #90-1120 12/31/2022 VI. COMMENTS Provide any additional comments here. Tank A is a 12K, Double Wall Fiberglass designated for Diesel. Tank B is a 12K, Double Wall Fiberglass designated for Super 91 Octane Gasoline. Tank C is a 12K, Double Wall Fiberglass designated for Regular 87 Octane Gasoline. VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer Smith FRP A ❑x B x❑ IC ❑x D ❑ A❑ B❑ I C I D❑ Test Method Used: ❑ Manufacturer Guidelines (Specify): ❑X Industry Code or Engineering Standard (Specify): PEI/RP1200-17/Fiberg lass Pipe/5 Psi 1 hour ❑ Engineered Method (Specify): # Attach the testing procedures and all documentation required to determine the results. of Attached Pages 2 Product Piping Containment Testing Training and Certifications (List applicable certifications.) Expiration Date ICC Service Technician #5246802-UT 3/21/2021 Under round Storage Tank Tester License #90-1120 12/31/2022 Interstitial Communication Verification Method Used: Release pressure at end of Piping Runs at UDC's where applicable. VIII. COMMENTS Provide any additional comments here. ID = Identification