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SECONDARY CONTAINMENT TESTING - REPORT FORIV <br />TESTING DATE: December 24. 2003 <br />1. OWNER INFORMATION <br />Name Pete Graffigna <br />Address 1301 W. Kettleman Ln., Lodi, CA 95242 Phone # 209-3343233 <br />contact Pete Graffigna <br />2. FACILITY INFORMATION <br />Name Flame Mini Mart <br />Address 1301 W. Kettleman Ln., Lodi, CA 95242 Phone # 209-334-3233 <br />contact Pete Graffigna <br />L LOCAL AGENCY INFORMATION <br />Name San Joaquin County Environmental Health Notified <br />Address 304 E. Weber Ave., 3rd Fir., Stockton, CA 95202 Phone # 209-468-9847 <br />Contact Michele Stemi-Le Fax # 209-468-3433 <br />Inspector Present No <br />4. TESTING CONTRACTOR INFORMATION <br />Name Walton Engineering, Inc. Lic # 617238 A, B, Haz <br />contact Michael Walton Phone# 916-373-1152 <br />Address P.O. Box 1025, West Sacramento, CA 95691 Fax # 916-373-1172 <br />Test Technician Philli2 Klin man <br />5. SUMMARY OF TEST RESULTS <br />Number of Tank Annulars 0 <br />Number of Secondary Lines 0 <br />Number of Piping Sumps 0 <br />Number of Spill Containers <br />Number of UDCs Tested <br />3 <br />0 <br />Component <br />Pass Fail <br />Component <br />Pass Fail <br />Annular - Tank #1 <br />Gasoline - 87 <br />Spill Container #1 <br />Gasoline - 87 <br />Annular - Tank #2 <br />Gasoline - 91 <br />Spill Container #2 <br />Gasoline - 91 <br />Annular - Tank #3 <br />Diesel <br />Spill Container #3 <br />Diesel 0 <br />Secondary Line #1 <br />Gasoline - 87 <br />U D C #1 <br />Disp # 1/2 <br />Secondary Line #2 <br />Gasoline - 91 <br />U D C #2 <br />Disp, # 314 <br />Secondary Line #3 <br />Diesel <br />U D C #3 <br />Disp # 5/6 <br />U D C #4 <br />Disp # 7/8 <br />Piping Sump #1 <br />Gasoline - 87 <br />Piping Sump #2 <br />Gasoline - 91 <br />Piping Sump #3 <br />Diesel <br />6. COMMENTS <br />This is an annual test of swill containers <br />Technician Signatursf��� Date <br />C 2003 Walton Engineering, Inc. <br />