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PnEGEIVED <br /> JAN 0 8 2016 <br /> ENVIRONMENTAL <br /> N�A1TI-1 nFF]IJRTAAt=SIT <br /> 1. FACILITY INFORMATION <br /> FacilitN Namc: Gas 4 Less -- - D,ac of Testing: 12/9115 <br /> Facility Address: 3434 Manthey Rd.,Stockton,CA 95106 <br /> I:acilit% C'ontact. I Phone (2()9)";1_7869 <br /> Date Local Agcnc%•Was Notified of I esting: 1 1/18/I5 SB989—3yr.Compliance Test <br /> Name of Local -\gene) Inspector(it presew during lesting): <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company Name:ABLE Maintenance.Inc. <br /> 'technician Conducting Test: James Moore/I.C.C.#5254517-UT <br /> Credentials: ® CSI_B Licensed Contractor SWRCB Licensed Tank fester <br /> License't'%pc:A,B,Haz.,CIO License Numher 312844 <br /> Manufacturer Training <br /> Manufacturer C'omponcnt(s) Date braining Expires <br /> Available upon request <br /> 3. SUMMARY OF TEST RESULTS <br /> Component: Pass Fail .Not Repairs Component: Pass Fail Not Repairs <br /> Tested Made Tested Made <br /> 87/91 lank Annularx❑ ❑ C17 <br /> 87 Secondary Product ❑ ❑ El <br /> 91 Sccondar� Product OO ❑ ❑ �❑x _- <br /> 87 Turbine Sump D ❑ ❑ <br /> 91 Turbine Su1111) ❑O ❑ ❑ ❑ <br /> UDC 1r © ❑ ❑ ❑ <br /> UDC 3/4 o ❑ ❑ ❑ <br /> UDC 5/6 ❑D ❑ ❑ <br /> UDC 7/8 OO ❑ ❑ (� <br /> UDC 9/10 i © l ❑ ❑ <br /> 87 Fill Sump ❑x ❑ ❑ 11 <br /> 91 Fill Sump 0 ❑ I ❑ ❑ <br /> If hydrostatic testing was performed.describe what was done �N ith the water atter completion of tests: <br /> Used pump test truck <br />