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\li \1% \ti \1% \1 ' di LED \ti \1% <br /> ir <br /> CERTIFICATE OF COMPLETION <br /> Interstitial Vacuum Test (IVT) <br /> For The <br /> PLASTEEL® Double-Wall Underground Tank <br /> I. Third Party Evaluation: This leak tightness Installation Location: <br /> test method has been third party evaluated per the Nitsl <br /> Alternate EPA Test Protocols for Plasteel International. 95 <br /> .vI. <br /> %��• The third party environmental consulting firm that <br /> performed the evaluation was: <br /> �. Ken Wilcox Associates, Inc. <br /> 19401 E.40 Highway, Suite 100 <br /> Independence,MO 64055 IV. Test Results: The interstitial vacuum test was <br /> 816 795-7997 performed per Appendix B. The following data was <br /> recorded: :i1515 <br /> A copy of the evaluation is on file at each licensed WN <br /> ►!% PLASTEEL®tank manufacturer and at: Nominal Tank Capacity: .1. <br /> !ice• (Gallons) .40. <br /> Plasteel International Inc. Primary Tank Product: <br /> 2541 State Street (air,gasoline, diesel,water) ':1: <br /> Carlsbad,CA 92008 !K <br /> (760)729-1093 Required Test Period: <br /> (Hours,per Appendix B,Figure 6.0) <br /> •\ri .1. <br /> II. Tank Description: Initial Gauge Reading: inches Hg. !i`• <br /> Date Time am/pm <br /> . Capacity: Gallons Final Gauge Reading: inches H <br /> g•�l1i i!. <br /> Date Time am/pm <br /> Jacketed: ' <br /> \1. Total Elapsed Time Period: a <br /> Composite: (Hours) <br /> Compartmented: Yes No Pass Fail (Initial) <br /> V. Statement of Test: I certify that the PLASTEEL® <br /> U.L.Number Double-Wall tank described above has been tested leak <br /> tight per Appendix B of the PLASTEEL® Tank <br /> ��. Installation Instructions. <br /> Tank Manufacturer: Testing Company: <br /> Name: Name: <br /> Address: Address: il ' <br /> III. Installation Information: Telephone: <br /> Tank Owner: <br /> Signatures, <br /> Name: <br /> Printed Name <br /> a Address: \I% <br /> Title <br /> \r, Date <br /> IVT-CERT 699 <br /> of\ti <br /> ��. 71�. <br />