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MAY-27-2011 17:31 Service Station Systems 408 938 8888 P.03 <br /> 1. FACILITY INFORMATION <br /> Facility Name: SHELL/USA#68153 Date of Testing: 4/29/11 <br /> Facility Address: 2448 W.Kettleman Lane—Lodi CA 95242 <br /> Facility Contact: Phonc: <br /> Date Local Agcncy Was Notified of Testing:4/21/11 SB989—Repair/Retest <br /> Name of Local Agency Inspector(if present during testing): <br /> 2. 'TESTING CONTRACTOR INFORMATION <br /> Company Name:ABLE Maintenance,Inc. <br /> 'technician Conducting Tcst: Marc Tillotson ICCO 5252033-UT <br /> Credentials: ® CSLB Licensed Contractor 7 SWRCB Licensed Tank Testcr <br /> License Type:A.S,Haz.,CIO License Number: 312844 <br /> 1f y <br /> Manufacturer Training <br /> Manufacturer Com nent s Date Training Expires <br /> Available upon request <br /> 3. SUMMARY OF TEST RESULTS <br /> Component: Pass Fail Not Repairs Component: I'ass Fail Not Repairs <br /> Tested Made Tested Made <br /> 91 Turbine Sump ® 0 ❑ IT D ❑ ❑ ❑ <br /> Diesel Turbine Sump W ❑ ❑ ® © ❑ ❑ ❑ <br /> ❑ ❑ . ❑ ❑ ❑ ❑ o ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> 0 0 ❑ ❑ ❑ Cl ❑ <br /> ❑ ❑ Q © ❑ ❑ ❑ ❑ <br /> ❑ C ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> D 11 11 <br /> ❑ :1 a ❑ El 11 © El <br /> ❑ ❑ ❑ a i <br /> if hydrostatic testing was performed, describe what was done with the water after completion of tests: <br /> Pump test truck used for testing <br />