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7149782615 0911 a.m. 10-20-2014 9/14 <br /> •Spill Bucket Testing Report Form <br /> This form is hnended foruse by contractors perfarming anmtal testing of USTsptll caMainment strrcnrres. The completed form and <br /> printouts from tests(irapplicable),should be provided to the fact1hy ownerloperatorforsubminal to the local regulatory agency. <br /> FACILITY INFORMATION Facili ID: PGE095 <br /> Facility Name: Pacific Gas and Electric Company Date of Testing:9/1572014 <br /> Facili Address:4040 WEST LANE,STOCKTON,CA 95204 <br /> Facility Contact: Alex Steele Phone: 209-736-6426 <br /> Date Local Agency Was Notified of Testing 2014-09-16 14 <br /> Name of Local Agency Inspector(ifpresent during tesring). Fatinah Zareef <br /> TESTING CONTRACTOR INFORMATION C;dG . <br /> HEALTH <br /> 'VT <br /> Company Name: TAIT Environmental Services,Inc. <br /> Technician Conducting Test: Victor Guerrero <br /> Credentials: r CSLB Contractor r ICC Service Tech r SWRCBTankTester rOther(Specify) <br /> License number(s):A B ASB C-]0 HAZ License Number 588095 : 8017001-UT <br /> SPILL BUCKET TESTING INFORMATION <br /> Test M ethod Used: rHydrostatic r-vacuum r Other <br /> Test Equipment Used: Tape Meesu re I Equipment Resolution: 1/16" <br /> Identify Spill Bucket(By Tmrk I Unleaded Diesel I Waste Oil <br /> Number,Stored Product,ete. <br /> Bucket Installation Type: F Direct Bury r Direct Bury F Direct Bury r Direct Bury <br /> F Contained in Swap r Contained in Sump r-Contained in Sump r Contained in Sump <br /> r On top of AST r On top of AST r On top of AST r On top of AST <br /> Bucket Diameter. Il" Il" it" <br /> Bucket Depth: 13.75" 12.75" 13.5" <br /> Wait time between applying 15 min. 15 min. 15 min. <br /> vacuum/water and start of test: <br /> Test Start Time(TI): 9:40 am 11:20 am 9:40 am <br /> Initial Reading(RI): 12.75" 12" 12.25" 11 <br /> Test End Time:(TF): 10:40 am 12:20 pm 10:40 am <br /> Final Reading(RF): 12.75" 12" 12.25" <br /> TestDwathm(TF-TI): Ihow Ihow Ihow <br /> Change in Reading(RF-Rlk 0 0 0 <br /> Pass/Fail Threshold or 0 0 0 <br /> Criteria: <br /> Test Result: r Pass r Fall F Pass r Fan F Pass r Fail r Pass r Fall <br /> Comments-(include infomwtion on repairs nmde prior m testing, and recommendedfoll ow-up for failed taws) <br /> All testwater was Ieft on site in a 25 gallon steel drum. <br /> Diesel spill bucket Initially failed;after repla dng/reusing an exlstingfill cap,the spill bucket passed. <br /> CERTIFICATION OFTECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> l hereby certify that d/the information contained in this report is true,accurate,and in full compl imuce 4th legal requirenum t. <br /> Technician's Signature: / _yz C~-Vo Date: 9/18/2014 <br />