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Lj <br /> UV 14 2014 <br /> I. FACILITY INFORMATION <br /> 3 iliSafeway #2600 ter. l�atc of'1"estinit: I0/16/14 <br /> — _ _. <br /> I-ttcititc Address: Ivey <br /> Facility Contact: I'hanc: (209)830-2950 <br /> Date Local Agency Wmi Notilled of Testing: 1012/14 w SB989—3vr.Compliance Test _...._..__,- <br /> vame of Loc;tl Agency Inspector(lfprevew durft(esrinK): <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company Nanw:ABLE Maintenance,Inc. <br /> "Technician Conducting Test: James Moore/I.C.C.#5254517-UT <br /> Credentials: ® CSLB Licensed Crnuracior SWRCR Licensed"rank Tester <br /> License Type:A,8,Waz.,CIOp�—� License Number: 312844 — <br /> Manufacturer TraininL 4� <br /> Manufacturer -_Components) Date Training Expires <br /> Available upon request I <br /> 3. SUMMARY OF TEST RESULTS <br /> Not Repairs Not Repairs <br /> Component: Pass Fail Component: (ass Fail <br /> Tested Made Not <br /> NIade <br /> 87 Tank.Annular (] 0 0 0 UDC 13/14 _ ® ❑ ❑ Lj <br /> 91/Diesel Tank Annular ; I] 0 ❑ ❑ UDC 15/16 !_ ,© .E ❑ �:' ❑ <br /> r <br /> ❑ ❑ <br /> 87 Secondary Product p 0 LJ 0 UDC. 17/18 O i _ <br /> ❑ <br /> 91 Secondary Product _ C] 0 ❑ UDC 19/20 ❑ 0 <br /> Diesel Secondary Product CK7 i 0 ❑ 87 Fill Sump p ❑ 0 0 <br /> 87 Turbine Sump D Q ❑ ❑ 91 Fill Sump f OO ❑ ❑ <br /> 9) Turbine Sump © 130 E) ` Diesel Fill Sump 7x ❑ 0 [- <br /> , <br /> Diesel Turbine Su;np ` [J 13 11 11 <br /> UDC 1/2 ® ❑ ❑ 0 <br /> U DC 3r4 © ❑ ❑ ❑ <br /> UDC 5/6 a <br /> U DC 7/8 <br /> ❑ ❑ ❑ <br /> I UDC 9/10 <br /> I f hydrostatic testing was performed,describe what was done with the water after completion of tests: <br /> Used pump test truck _.--- <br />