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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 <br />entify Tank ID from Section III <br />for each Manufacturer <br />XERXES <br />A EB <br />A❑ I <br />x❑ <br />B❑ I <br />C Q <br />C❑ I <br />D❑ <br />D❑ <br />Test Method Used: <br />❑ Manufacturer Guidelines (Specify): <br />❑x Industry Code or Engineering Standard (Specify): PEI/RP1 200-1 7/Fiberglass Tank/-10" <br />Hg. 1 Hour <br />❑ Engineered Method (Specify): <br />Attach the testing procedures and all documentation required to determine the results. <br /># of Attached Pages <br />2 <br />Tank Containment Testing Training and Certifications (List applicable certifications) <br />Expiration Date <br />ICC Service Technician #5246802-UT <br />3/21/2021 <br />Underground Storage Tank Tester License #90-1120 <br />12/31/2022 <br />VI. COMMENTS <br />Provide any additional comments here. <br />Tank A is a 19,703 Gallon, Double Wall Fiberglass designated for Regular 87 Octane Gasoline. <br />Tank B is a 11,849 Gallon, Double Wall Fiberglass designated for Plus 89 Octane Gasoline. <br />Tank C is a 10,369 Gallon, Double Wall Fiberglass designated for Super 91 Octane Gasoline. <br />VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br />Manufacturer <br />Identify Tank ID from Section III for each Manufacturer <br />Ameron FRP <br />AN <br />A❑ <br />I BN <br />B❑ <br />xQ <br />C❑ <br />D ❑ <br />D❑ <br />Test Method Used: <br />❑ Manufacturer Guidelines (Specify): <br />❑x Industry Code or Engineering Standard (Specify): PEl/RP1200-17/Fiberglass Pipe/5 <br />Psi 1 hour <br />❑ Engineered Method (Specify): <br />Attach the testing procedures and all documentation required to determine the results. <br /># <br />of Attached Pages <br />2 <br />Product Piping Containment Testing Training and Certifications (List applicable certifications.) <br />Expiration Date <br />ICC Service Technician #5246802-UT <br />3/21/2021 <br />Underground Storage Tank Tester License #90-1120 <br />12/31/2022 <br />Interstitial Communication Verification Method Used: <br />Release pressure at end of Piping Runs at UDC's where applicable. <br />VIII. COMMENTS <br />Provide any additional comments here. <br />ID =Identification <br />