Laserfiche WebLink
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 /> Arrow Tank A x❑ B x❑ C ❑ D ❑ <br /> A ❑ B I C ❑ I D ❑ <br /> Test Method Used: ❑ Manufacturer Guidelines(Specify): <br /> ❑p Industry Code or Engineering Standard(Specify): PEI/RP 1200-17/Steel Tank -6Hg. 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 3/20/2021 <br /> Underground Storage Tank Tester License #90-1120 12/31/2019 <br /> VI. COMMENTS <br /> Provide any additional comments here. <br /> Tank A is a 1 OK Jacketed Double Wall Steel containing Regular 87 Gasoline. NA-Tank A not tested with this testing <br /> event. <br /> Tank B is a 1 OK Jacketed Double Wall Steel containing Diesel Fuel. <br /> VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> A ❑ B ❑ I C D ❑ <br /> A ❑ B ❑ I C I D ❑ <br /> Test Method Used: ❑Manufacturer Guidelines(Specify): <br /> ❑ Industry Code or Engineering Standard (Specify): <br /> ❑Engineered Method(Specify): <br /> #of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> Product Piping Containment Testing Training and Certifications(List applicable certifications.) Expiration Date <br /> Interstitial Communication Verification Method Used: <br /> VIII. COMMENTS <br /> Provide any additional comments here. <br /> NA-Product Piping not tested with this testing event. <br /> ID=Identification <br />