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i <br /> 1. FACILITY INFORMATION <br /> Facility Name: Food 4 Less I Date of Testing: 2/19/13 <br /> Facility Address: 3408 Manthey Road—Stockton CA 95206 <br /> Facility Contact: Phone: <br /> Date Local Agency Was Notified of Testing:2/15/13 SB989 - Repair&Re-test <br /> Name of Local Agency Inspector(if present during testing): <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company Name:ABLE Maintenance,Inc. <br /> Technician Conducting Test: James Moore/I.C.C.#5254517-UT <br /> Credentials: ® CSLB Licensed Contractor ❑SWRCB Licensed Tank Tester <br /> License Type:A,B,Haz.,C10 License Number: 312844 <br /> Manufacturer Training <br /> Manufacturer Component(s) Date Training Expires <br /> Available upon request <br /> 3. SUMMARY OF TEST RESULTS <br /> Component: Pass Fail Not Repairs CNot Repairs <br /> p Tested Made Component: Pass Fail 'rested Made <br /> UDC 9/10 px ❑ 0 px <br /> l� <br /> If hydrostatic testing was performed,describe what was done with the water after completion of tests: <br /> Used pump test truck <br />