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Alltech Petro Inc. <br /> 17759 Buttercup Circle, Sonora, CA 95370 ` <br /> Phone: 209-532-7320; Fax: 209-533-2650 <br /> California Contractor 623541 A-Haz 1 <br /> ICC Technician: 5259412-UT <br /> SWRCB Tank Tester: 90-1068 <br /> mike@,alltechpetro.coin <br /> Spill Bucket Testin¢ Report Form <br /> FACILITY INFORMATION: <br /> Facility Name: Costco 658 Tracy Date of Testing: Thursday,September 20,2007 <br /> Facility Address: 3240 W.Gtrant Line Rd Tracy CA <br /> Facility Contact: Robert Mendoza Phone: 95304 <br /> Notification Date of Local Agency:8/11/2007 <br /> Name of Local Agency Inspector:Michelle,Willy <br /> SPILL BUCKET TESTING INFORMATION: <br /> Test Method Used: ®Hydrostatic ❑Vacuum ❑Other <br /> Test Equipment Used: 1-Hour Observed Test Equipment Resolution: 1/16" <br /> ffleM— <br /> Identify Spill Bucket 1 Reg 1 2 Reg 2 3 Prem 4 <br /> Bucket Installation Type: Lj Direct Bury M Direct Bury Direct Bury Direct Bury <br /> In sump Z In Sump ED In Sump ❑In Sum <br /> Wait time between applying None None None <br /> vacuum/water and start of test: <br /> Test Start Time(T,): 08:15 08:15 08:15 <br /> Initial Reading(Rj: Top of Adapter Top of Adapter Top of Adapter <br /> Test End Time(Tr): 09:15 09:15 09:15 <br /> Final Reading(RF): Top of Adapter Top of Adapter Top of Adapter <br /> Test Duration(TF—T,): 1.0 Hr. 1.0 Hr. 1.0 Hr. <br /> Change in Reading(RF-R,): 0.0 0.0 0.0 <br /> Pass/Fail Threshold or 1/16" 1/16" 1/16" <br /> Criteria: <br /> Test Result: ® Pass ❑Fail ® Pass ❑Fail ® Pass ❑Fail ❑ Pass ❑Fail <br /> Comments—(include information on repairs made prior to testing,and recommended follow-up forfailed 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:_ 114 Z?02-d`ea Date: <br />