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Feb 251412:50a Reliable Petroleum <br /> p <br /> ` 02!2412014 8:17PN FAX 925253 Guadalupe Sanchez p -000 02 <br /> FEB 252014 <br /> SWRCB,January 2006 <br /> Spill Bucket Testing Report "WWONMENTAL HEALTH <br /> This form is intended for use by contractors performing annual testing of UST spill eontainmDERARIM 0WTmp/eted form and <br /> printouts from testy(rfapplieable),should be provided to the facility miner/operator for submitral io the local regulatory agency. <br /> 1. FACILITY INFORMATION <br /> Facili Name: ARCO Date of Testing: 11/19/2013 <br /> Facility Address: 4855 S.State Route 9,Stockton,Ca.95215 <br /> Facility Contact: Gill Phune. (209)481.7445 <br /> Dale local Agency Was Notified o r Testing <br /> Name of Local Agency Inspector(rfpresent during resting)! Stacy Rivera <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company Name., Reliable Petroleum Services Inc. <br /> Technician Conducting Test Guadalupe Sanchez <br /> Credentials': x CSLB Contractor x ICC Service Tech. n SWRCB Tank Tester U Other(Specify) <br /> License Number(s): 883706 5250451 <br /> 3. SPILL BUCKET TESTINGINFORMATIION <br /> Test Madiod Uaed: xHydrostatic _ ❑Vacuum 13Other <br /> 'fest Equipmew Used: Standard Tape Mcasure Equipment Resolution_ N/A <br /> Identify Spill Bucket(By Tank 171:87 Fill SE 2 Tl:87 Fill NE 3 T2: 89 Fill 4 T3:91 Fill <br /> Number,Stored Product, ere) <br /> Bucket lnatallatian Type: Direct Bury Direct Bury Direct Bury Direct Bury <br /> x Contained in Sum x Contained in Sump x Contained in Susnp x Contained in Sumv <br /> Bucket Diameter: 12" 12" _ l2" 12" <br /> Buoket Depth: 13 '/." 13 3/4" 133/4 13 <br /> Wait time between applying - <br /> vacuumtwoter and start of test: I minute 1 minute I minute I minute <br /> Test Start Time Cl): 12:42 p,m. 12:42 p.m. 12:42 p.m. 12:42 p.m. <br /> Initial Reading(RO: 11 i/8" 115/8" 12" 113/:' <br /> Test Lind Time(Tr): 1:42 p.m. 1:42 pm. 1:42 p.m. <br /> Final Reading(RF): I t 118" 11 54" 12" <br /> Test Duration(Tr-TI): I hr 1 kr I hr 1 hr <br /> Change in Reading(RF-R,): 0 0 _ 0 0 <br /> Pass/Pail'11ireshold or <br /> Criteria: 1116" 1116" 1/16" U16" <br /> Test Reault: n Pe0 0 Fail x Pass 17 Fail x Pass D Fall Lx Paas D Fail <br /> Comments-(include information an repairs made prior to to ting and recommendedjolfow uDfor faded tew) <br /> CERTEFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> 1 hereby certify that all the inforrmtr6o�n co mbied in tlds repots is true,accurate,and hifull compliance 491/t legal reyuiremena. <br /> Technician's -ncDate 111119r2013 <br /> State laws and regulations do not currently require testing tv be pertbrmed by a qualified contmeton However, local requirements <br /> may be mare stringeaL <br />