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Secondary Containment Testing Report Form <br /> Hancock Petroleum Engineering SSP 7 2002 <br /> 3320 Industrial Drive,Yuba City,Ca 95993-9202 (530)671-3642 (530)671-1198-Fax Ca. Lies.478AU%VT HEALTH <br /> VICES <br /> www.hancockpctro.com <br /> 1. FACILITY INFORMATION <br /> Facility Name: P.G. & E. I Date of Testing: 09/23/02. <br /> Facility Address: 4040 West Lane, Stockton, Ca 95204 <br /> Facility Contact: James Jarvis Phone: (209) 942-1566 <br /> Date Local Agency Was Notified of Testing: 09/20/02 <br /> Name of Local Agency Inspector(if present during testing): <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company Name: Hancock Petroleum Engineering <br /> Technician Conducting Test: Kelly Roberts <br /> Credentials: X CSLB Licensed Contractor SWIRCB Licensed Tank Tester <br /> License Type: Class A Haz License Number: 478000 <br /> Manufacturer Trainine <br /> Manufacturer Component(s) Date Training Expires <br /> Incon 8 TS-STS 08/02/05 <br /> 3. SUMMARY OF TEST RESULTS <br /> Component Pass Fail Not Repairs Component Pass Fail Not Repairs <br /> Tested Made Tested Made <br /> TAT#1 Tank Annular Testing F✓ Ell LLJ SOCB#2 0 F-1 Lj <br /> TAT#2 F.-/-] E::] = SOCB#3 F—V] F 0 <br /> TAT#3 EiEl I = 1 S0C13#4 F-1 0 0 <br /> TAT#4 Q I I0 0 <br /> SPT#1 Secondary Pipe Testing [ V Q 0 0 <br /> SPT#2 �✓ [� [ 0 <br /> PST#1 Piping Sump Testing U <br /> PST#2 5711 <br /> 0 Q 0 <br /> UDC#I Under Disp.Cont.Testing 0 0 0 0 0 <br /> UDC#IA F-1 a <br /> UDC#2 [✓ 0 0 0 <br /> SOCB#1 Spill/Overfill Cont.Test IT = <br /> If hydrostatic testing was performed,describe what was done with the water after completion of tests: <br /> Water will be removed from all test containers and filtered through a charcoal activated filtration system <br /> And returned to our on board storage tanks. <br /> CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> To the best of my knowledge,the facts stated in this document are accurate and in full compliance with legal requirements <br /> Technician's Signature:_ Date: 09/23/02 <br />