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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT <br /> V. TANK SECONDARY CONTAINMENT INFORMATION (ANNULAR) <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer. <br /> A❑ B ❑ C❑ D❑ <br /> A❑ B ❑ C D❑ <br /> Test Method Used: ❑ Manufacturer Guidelines: <br /> ® Industry Code or Engineering Standard: PEI/RP1200/vacuum Test/10Hg for 1 hr. <br /> ❑ Engineered Method: <br /> Attach the testing procedures and all documents required to determine the results. #of Attached Pages: <br /> Tank Containment Testing Training and Certifications Expiration Date <br /> ICC Service Technician- <br /> VI. COMMENTS <br /> N/A -- ' EIVED <br /> SEP 14 20, <br /> �'��l'�>�0111V;11A��lfui;�1'1.. t l I•:,�1���t t=1 <br /> VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION (SECONDARY LINE) <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> A B ❑ C -- -- D❑ <br /> A B ❑ C❑ D ❑ <br /> Test Method Used: ❑ Manufacturer Guidelines: <br /> ® Industry Code or Engineering Standard: PEI/RP12oo/Pressure Test/5 psi for 1 HR <br /> ❑ Engineered Method: <br /> Attach the testing procedures and all documentation required to determine the results # of Attached Pages: <br /> Product Piping Containment Testing Training and Certifications — Expiration Date— <br /> ICC Service Technician- <br /> Interstitial Communication Verification Method Used: <br /> VIII. COMMENTS <br /> N/A <br />