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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 /> Trusco A x❑ B x❑ I C ❑x D ❑ <br /> A ❑ B ❑ I C ❑ I D ❑ <br /> Test Method Used: ❑ Manufacturer Guidelines(Specify): <br /> X Industry Code or Engineering Standard(Specify): PEI/RP 1200-17/Glass Steel Tank/-10 Hg. 1 hr. <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 /> Under round Storage Tank Tester License #90-1120 12/31/2022 <br /> VI. COMMENTS <br /> Provide any additional comments here. <br /> Tank A &Tank B, is a 15K, Two Compartment, Double Wall Glass Steel. Tank A is designated for 6K Diesel, and Tank B <br /> is designated for 9K Super 91 Octane Gasoline. <br /> Tank A&Tank B have a common Tank Secondary Containment. <br /> Tank C is a 15K, Double Wall Glass Steel designated for Regular 87 Octane Gasoline. <br /> VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Ameron FRP LCX AI B El I C ❑x D ❑ <br /> A 1 E3 El I C ❑ I D ❑ <br /> Test Method Used: ❑Manufacturer Guidelines(Specify): <br /> ❑D Industry code or Engineering standard (Specify): PEI/RP 1200-17/Fiberglass Pipe/5 Psi 1 hr. <br /> ❑ Engineered Method (Specify): <br /> Attach the testing procedures and all documentation required to determine the results. #of Attached Pages2 <br /> Product Piping 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 /> Interstitial Communication Verification Method Used: <br /> Release pressure at end of Product Piping Containment runs at UDC's where applicable. <br /> VIII. COMMENTS <br /> Provide any additional comments here. <br /> ID=Identification <br />