Laserfiche WebLink
SWRCB,January 2006 <br /> 9. S ' Bucket Testing Report arm <br /> This form is intendbd for use by contractors performing annual testing of USTspill containment structures. The comp/etedform and <br /> printouts from tests(if applicable),should be provided to the facility owner/operator for submittal to the local regulatory agency. <br /> 1. FACILITY INFORMATION <br /> Facility Name: TRACY PETRO I Dateof Testing: 02/25/2011 <br /> Facility Address: 3400 N. MACARTHUR DR TRACY, CA, 95376 <br /> Facility Contact: KARAM S INGH Phone: (2 0 9) 814-8581 <br /> Date Local Agency Was Notified of Testing <br /> Name of Local Agency Inspector(if present during testing): THUY TRAN <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company Name: TANKNOLOGY, INC. <br /> Technician Conducting Test: KELVIN CRUZ <br /> Credentials 1: M CSLB Contractor ❑X ICC Service Tech. ❑SWRCB Tank Tester E Other(Spec) CONTRACTOR <br /> License Number: 743160 <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: El Hydrostatic ❑ Vacuum ❑ Other <br /> Test Equipment Used:TAPE MEASURE Equipment Resolution:1/16'� <br /> Identify Spill Bucket(By Tank 1 PRE FILL 2 2 REG FILL 3 3 DIE FILL 4 <br /> Number, Stored Product, etc) <br /> ❑Direct Bury ❑Direct Bury E]Direct Bury ❑Direct Bury <br /> Bucket Installation Type: <br /> X❑Contained in SumpX❑Contained in Sump ❑X Contained in Sump ❑ Contained in Sump <br /> Bucket Diameter: 12 12 12 <br /> Bucket Depth: 13 14 13 <br /> Wait time between applying SMIN 5MIN 5MIN <br /> vacuum/water and starting test: <br /> Test Start Time(Ti ): 0950 0950 1035 <br /> Initial Reading(Rt ): 12 3/8 14 12 3/4 <br /> Test End Time(TF ): 1050 1050 1135 <br /> Final Reading(R F ): 12 3/8 14 12 3/4 <br /> Test Duration: 1HR 1HR 1HR <br /> Change in Reading(R F-R1 ): 0 0 0 <br /> Pass/Fail Threshold or 0 0 0 <br /> Criteria: <br /> Sil 's F` <br /> Comments- (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br /> CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> I hereby certify that all the information contained in this report is true,accurate,and in full compliance with legal requirements. <br /> Technician's Signature: � Date: 02/25/2011 <br /> State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements <br />