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UNDERGROUND STORAGE TANK SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of s) V. TANK SECONDARY CONTAINMENT INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer Modern Welding A EB x❑ C ❑x D F] A ❑ B ❑ I C ❑ D ❑ Test Method Used : ❑ Manufacturer Guidelines (Specify) : p Industry Code or Engineering Standard (Specify) : PEI / RP1200 - 17/Glass Steel 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 4/3/2019 Underground Storage Tank Tester License #90 - 1120 12/31 /2019 VI . COMMENTS Provide any additional comments here. Tank B & C is a 12K Double Compartment Split 6k Super 91 and 6K Diesel , with a Single Tank Secondary Containment. VII . PRODUCT PIPING CONTAINMENT TESTING INFORMATION Manufacturer Identify Tank ID from Section III for each Manufacturer Smith Fibercast FRP A D BE c D ❑ A ❑ I B ❑ I C ❑ I D ❑ Test Method Used : ❑ Manufacturer Guidelines (Specify) : Z Industry Code or Engineering Standard (Specify) : PEI /RP1200 - 17/ Fiberglass Pipe/5 Psi 1 hour ❑ Engineered Method (Specify): # of Attached Pages Attach the testing procedures and all documentation required to determine the results. 2 Product Piping Containment Testing Training and Certifications (List applicable certifications.) Expiration Date ICC Service Technician #524680MT 4/3/2019 ii Underground Storage Tank Tester License #90- 1120 12/31 /2019 Interstitial Communication Verification Method Used : Release pressure at end of Piping Run by loosing clamp on Test/Seal off Boots at UDC's when applicable . VIII . COMMENTS Provide any additional comments here. ID = Identification