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Deg301306:03a Reliable Petroleum 2098458953 <br /> p.2 <br /> RECEIVED <br /> SWRCB,January 2006 <br /> Spill Bucket Testing Report Form P7 3 0 2013 <br /> This form is intendedfor use by retractors performing annual testing of UST spill containment sire pyo� ® d <br /> printouts from tests(ifapplicable, should be provided to the facility owner/operator for submittal to thp. Iq <br /> 1. FACILITY INFORMATION <br /> Facility Name: ARCO I Date of Testing: 11/302011 <br /> Facility Address: 4855 State Route 9, Stockton,W5215 <br /> Facility Contact: Gill Phone: (2D9)481-7445 <br /> Date Local Agency Was Notified fTesting: //-13-/2- <br /> Name of Local Agency Inspector Wpresent during testing): Stacy Rivera <br /> 2. 1 TESTING CONTRACTOR INFORMATION <br /> Company Name: Relia le Petroleum Services Inc. <br /> Technician Conducting Test Guadalupe Sanchez <br /> Credentials': x CSLB Contract x ICC Service Tech. 7 SWRCB Tank Tester ❑Other(Specify) <br /> License Number(s): 8$3706 5250451 <br /> SPILL.BUCKET TESTING INFORMATION <br /> Test Method Used: Hydrostatic ❑Vacuum E Other <br /> Test Equipment Used: Standard ape Measure Equipment Resolution: <br /> Identify Spill Bucket(By Tank TI:87 Fill SE 2 Tl:87 Fill NE 3 T2: 89 Fill 4 T4:91 Fill <br /> Number,Stored Product, etc. <br /> Bucket Installation Type: Direct Bury Direct Bury Direct Bury Direct Bury <br /> Contained in S x Contained in Sum x Contained in Sum x Contained in Sum <br /> Bucket Diameter: 12" 12" 12" 12" <br /> Bucket Depth: 13 VP 13 Y:" 13'/." 13'/." <br /> Wait time between applying I minute l minute I minute I minute <br /> vacuum/water and start of test: <br /> Test Start Time(T,): 2:27 p.m. 4:01 p.m. 4,00 p.m. 2:25 p.m. <br /> Initial Reading(R,): 12" 11718" 11 7/8" 12" <br /> Test End Time(TF): 3:27 p.m. 5:01 P.M. 4:00 p.m. 3:25 p.m. <br /> Final Reading(Rr): 12" 11718" 117/8" 12" <br /> Test Duration(TF-T,): 1 hr 1 hr I hr 1 hr <br /> Change in Reading(RF-R): 0 0 0 0 <br /> Pass!Fail Threshold or 1116" 1116" 1/16" 1/l6" <br /> Criteria: <br /> Test Result: x Pass . O Fail x Pass ❑Fail x Pass ❑Fail x Pass ❑Fail <br /> Comments- include inform ion on repairs made prior to testing, and recommended ollow-u or ailed tests <br /> CERTIFICATIO 4 OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> I hereby tangy that all the hsf station contained in this report is doe,accurate,and in full compllance with legal requirements. <br /> Technician's Signature, Date 11/192012 <br /> 'State laws and regulations don currently require testing to be performed by a qualified contractor.However,local requirements <br /> may be more stringent. <br />