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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 /> Modern Weldinq I A Q I B Q C x❑ D <br /> A ❑ I B ❑ I C ❑ I D ❑ <br /> Test Method Used : 171 Manufacturer Guidelines (Specify) : <br /> Mx Industry Code or Engineering Standard (Specify): PEI /RP 1200 - 17/Glass Steel Tank/- 10 Hg . 1 hr. <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 3/21 /2021 <br /> Underground Storage Tank Tester License #90 - 1120 12/31 /2022 <br /> VI . COMMENTS <br /> Provide any additional comments here. <br /> Tank A is a 1 OK Double Wall Glass Steel , designated for Regular 87 Octane Gasoline . <br /> Tank B & Tank C is a 12K Two Compartment, Double Wall Glass Steel . Tank B is designated for 8K Super 91 Octane <br /> Gasoline . Tank C is designated for 4K Diesel . <br /> Note : Tank B , and Tank C , have a common Tank Secondary Containment. <br /> VII . PRODUCT PIPING CONTAINMENT TESTING INFORMATION <br /> Manufacturer I Identify Tank ID from Section III for each Manufacturer <br /> Advanced Polymer Technolo A X B x❑ C Fxj D ❑ <br /> A I B ❑ C ❑ I D ❑ <br /> Test Method Used : ❑ Manufacturer Guidelines (Specify) : <br /> Mx Industry Code or Engineering Standard (Specify) : PEI /RP 1200 - 17/Flexable Pipe/5 Psi 1 hr. <br /> ❑ Engineered Method (Specify) : <br /> # of Attached Pages <br /> Attach the testing procedures and all documentation required to determine the results. 2 <br /> Product Piping Containment Testing Training and Certifications (List applicable certifications.) Expiration Date <br /> ICC Service Technician #5246802- UT 3/21 /2021 <br /> Underground Storage Tank Tester License #90 - 1120 12/31 /2022 <br /> Interstitial Communication Verification Method Used : <br /> Release pressure at end of Product Piping Containment runs at UDC 's where applicable . <br /> VIII . COMMENTS <br /> Provide any additional comments here. <br /> ID = Identification <br />