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Aug 29 13 04:47a Reliable Petroleum 2098458953 P.11 <br />'08/29/2013 11:18AMM FAX 82523 3 Guadalupe Sanchez 180010/0010 <br />S WRC:B, January 2006 <br />Spill Bucket Testing eport Forth <br />This form is interidedfor use by c®nrractollPerforming annual testing of'UST sPW containment structures, The completed for®n and <br />prinrouts from tests (f applicable), should be provided io the facility a wnerlopervlar fir .submittal to the laced rVulatory agency. <br />Faailit Name: Statewide Petroleum ( Valero) Date of Testi 97 7/2912013 <br />Facility Address: 1700 E. Yosemite Ave., Manteca, Ca. 95336 <br />Facility Contact: Sonny Phony: (408) 230-5999 <br />Dole Local Agency was Notified of Tasting. 0n -1 q-/.3 <br />Name of Local Agency Inspector (if present during t Aris Cacapit <br />2. TESTING CONTRACTOR INFORMATION <br />Company Name: Reliable Petroleum Services.. Inc. <br />TConducting Test: ConductTest: Guadalupe 5 z <br />Credentials'. x CSLB Contractor x ICC Service Tech, 0 SWRCB Tank Tester i7 Ocher (Specify)_ <br />License Number(s): 883705 5250451 -UT - <br />Test Method Used: <br />x Nydros:atic <br />t I Vacuum <br />0 Other <br />Teat Equi meat Used: Standard Tape Mtwure <br />Equipment Resolution. NIA <br />Mentify Spill Bucket (13y Tank <br />!dumber, Stored Product, et C. <br />IT 1: 871Fi1i <br />Z TZ. 91111111 <br />3 4 <br />Bucket Installation T <br />Type: <br />x Direct Bury <br />0 Contained in Sump <br />x Direct Bury <br />❑ Contained in Sump <br />0 Direct Bury 0 Direct Bury <br />d Contained in Sump-- ❑ Contained in S <br />Bucket Diameter. <br />12" <br />12" <br />]Bucket Depth: <br />1311/41, <br />14" <br />Wait ohne between applying <br />vacuum/water and start of test: <br />1 minute <br />1 minute <br />Test Start'1'ime ('i't): <br />9:14 a.m. <br />9:14 a m. <br />Initial Reading (R,), <br />32 %" <br />13" <br />Tc.it End Time (Tp): <br />10:14 &m. <br />10:14 a.m. <br />Final Reading (Rs): <br />12 %" <br />13" <br />Test Duration (Tr - Tt): <br />1 hr <br />l hr <br />Change in Reading M. - Ra): <br />0 <br />0 <br />Pass/Fail Threshold or <br />Criteria <br />1/16" <br />1116" <br />Text Result: <br />x pass ❑ Full <br />x Pass 17 trail <br />0 Pass 0 Fall 13 Pass 0 Fail <br />UOMMMts - (i►aclude infarmarion an repairs modeprior da testing and recommendedfollow-upforfailed tests) <br />CERTIFICATION OF TECHNICIAN RESPONS€BLR WOR CONDUCTING TIUS TESTING <br />I hereby certkfp that rill tke k0rtnartiUrr Contained in this report is tragi, accurate, and infuM compliance with legal requiremenJ& <br />Technician's sign — / Def 729/2013 <br />State laws and replations des not currently requite testing to be peifa med by a qualified contractor. However, local requirements <br />xray be more stringent. <br />