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405/14Y2008 21:43 FAX 2095332650 ALLTECH PETRO INC Muni Naidu IM004 <br />Spill Bucket Testing Report Form <br />I_ F4CILITYINFORM4TION <br />Facility Name: Mossdale Arco Date of Testing: 4/28/2008 <br />Facility Address: 444 Mossdale Road, Lathrop CA <br />Facility Contact: Nick Bokides Phone: (209) 234-1256 <br />Date Local Agency Was Notified of Testing: <br />Name of Local Agency Inspector (1 present during testing): Muniappa Naidu <br />2. TESTING CONTRACTOR INFORMATION <br />Company Name: Alltech Petro Inc, 17759 Buttercup Circle, Sonora CA 95370. (209) 532-7320 <br />Technician Conducting Test: David Hanson ICC Certification: 8003789 -UT Expiration: 2/9/2010 <br />Credentials`: ❑ CSLB Contractor ® ICC Service Tech. ❑ SWRCB Tank Tester ❑ Other (Spec fi) <br />License Number(s): <br />Test Method Used: <br />®H drostatic <br />❑ Vacuum <br />❑Other <br />Test Equipment Used: One Hour Observed Test <br />Equipment Resolution: <br />1/16" <br />Identify Spill Bucket <br />1 87 <br />2 91 <br />3 DSL <br />4 <br />Bucket Installation Type: <br />® Direct Bury <br />In Sump <br />® Direct Bury <br />El In Sump <br />® Direct Bury <br />D In Sum <br />[I Direct Bury <br />In Sum <br />Wait time between applying <br />vacuum/water and start of test: <br />0 <br />0 <br />0 <br />Test Start Time (Ti): <br />9:30 <br />9:30 <br />9:30 <br />Initial Reading (RT): <br />Top of Cap <br />Top of Cap <br />Top of Cap <br />Test End Time (TF): <br />10:30 <br />10:30 <br />10:30 <br />Final Reading (RF): <br />Top of cap <br />Top of cap <br />Top of cap <br />Test Duration (TF — TT): <br />1.0 Hr. <br />1.0 Hr. <br />1.0 Hr. <br />Change in Reading (RF - R4): <br />0.0 <br />0.0 <br />0.0 <br />Pass/Fail Threshold or <br />Criteria: <br />0 <br />0 <br />0 <br />'cet:Result <br />. <br />Pass. ;❑:Fail; :: <br /><:.. Fa,�.: <br />.. Pass Fail.:...,... <br />; <br />Pass <br />Comments: <br />CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br />Technician's Signature: �,,. Digitally signed by David Hanson <br />Date: 2008.05.03 10:32:39 -07'00' <br />