Laserfiche WebLink
08/22/2012 11:44AN FAX 2093330318 RSM CORP 0007/0008 <br /> SWRCB,January 2006 <br /> Spill Bucket Testing Report Farm <br /> This form is irate for use by contmotoew jrf owning annual testing of U.S7~kill containment structures. The completed form and <br /> printouts from tests(rf applicable),should be provided to the facility ownerloperator for submittal to th4 local regulatory agency. <br /> 1.FACILITY INFORMATION <br /> Facility Name: KETTLEMAN CHEVRON Date of Testing: 8-10-12 <br /> Facility Address: 601 F.KETTLEMAN LN LOTH C A <br /> Facility Contact: TONY Fktone: <br /> [Nt4 Local Agency Was Notified of Testin :8-1-12 <br /> Name of Local Agency lnspcvtor(if present inuring tewting�: Not present <br /> 2.TESTING CONTRACTOR INFORMATION <br /> Company Name: AFFORDA TEST 416 2"Street Galt.CA 95632 (209)744.0112 Fax:(209)744-0116 <br /> 1'cchnician Conducting Test: Lyle D.Nirnmo ❑ Zane A.Nimmo I( David A. Winkler n Felix G.Ramirez <br /> 5249115-UT 5263322-UT 5263373-UT 5273934-UT <br /> Credentials': ®ICC Service Tech. SWRCB Tank Tester <br /> 3.SPILL BUCKET TESTING INFORMATION <br /> Test Method used: ® Hydrostatic []Vacuum Q Other <br /> Test Equipment Used: h20 and tape measure Equi mart Resolution: 1/16 <br /> Identify Spill Bucket(By Tank 2 87 E <br /> Number,Stored Product,etc,. 71 <br /> Bucket installation Type: Q"��B1 <br /> Containedd in Sum <br /> Bucket Diameter: 11 <br /> Bucket Depth: 15 <br /> Wait time between applying _ <br /> vacuum/watcr and start of test: <br /> Test Start Time(T°): 2FM <br /> Initial Reading(R,): 14 <br /> Test End Time(TF): 3FM <br /> Fiala) Rcading(RF): 14 <br /> Test Duration(Tp`—T°): 11 Ili <br /> Change in Reading(Rr-R,): 0 <br /> Pass/Fail Threshold or 1/16 <br /> Criteria <br /> tie....a .....•r,,:..°EY'f•r nr+ y..yt N M <br /> 6•ra^:,::+��r f%`a.:k!Wui i 'a Cl,.......... <br /> .{ <br /> f �� t,r,r,,:[ §bS;pr ! f 3i ,r,i% r i r S El;,• ¢i,rart, f s ?a,:a. $ !�dliS:jr ,ye i4'ni%i� <br /> A,.s: "S^ r <br /> 4....r.;...:..._,..n.,.r?, {a.$snai=:,r [r,, �a�l,n•:;,-a;r?.... � x AI,itlis[:n;,r,�si�r1:.+.4kSN,;�:!:•"1rtry., <br /> Comments—(include information on <br /> 'pairs made prior to tesliXg and recvmmcAnded fallow-up for fail<.tl tests) <br /> CERTin(wrION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TF-SUING <br /> I hereby Certify that all the information contained in this report is true,accurate,and in full compliance with lept requirements. <br /> Technician's Signature: Date 8-10-2012 <br /> ° State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements <br /> may be more stringent, <br />