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UNDERGROUND STORAGE TANK <br /> SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of s) <br /> V. TANK SECONDARY CONTAINMENT INFORMATION <br /> Manufacturer I Identify Tank ID from Section III for each Manufacturer <br /> Trusco I AZ 130 C ❑ I D ❑ <br /> A ❑ B ❑ I C ❑ I D ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify) : <br /> ® Industry Code or Engineering Standard (Specify): Vacuum <br /> ❑ Engineered Method (Specify): <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. <br /> Tank Containment Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> ICC UST Certification # 8819839 10/25/2019 <br /> VL COMMENTS <br /> Provide any additional comments here. <br /> 87/91 Tank annular manifolded . Tested at 11 : 00 am at 7 hg ended at 12 : 00 pm at 7 hg . <br /> * Note: inspector not present on 08/13/2019 <br /> VII . PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer Identify Tank ID from Section III for each Manufacturer <br /> Smith 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) : Pressure <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 /> ICC UST Certification # 8819839 10/25/2019 <br /> Interstitial Communication Verification Method Used : <br /> VIII . COMMENTS <br /> Provide any additional comments here. <br /> 87 , 91 secondary lines tested at 10 : 30 am at 5 psi ended at 11 : 30 am at 5 psi . <br /> ID = Identification <br />