Laserfiche WebLink
SWRCP,,January 2002 <br /> Page I of 7 <br /> Secondary Containment Testing Report Form <br /> Stockton Service Station Equipment Co., Inc. <br /> 808 N. Utuon Street, Stockton, CA 95205-4152 (209)464-8333 FAX (209)464-8349 <br /> California Contractor Licensc 309105 A-C61/D40 HAZ/1-ITC E-Mafissseco 4mcbell.nq! <br /> FaciltName, dank orStockton 1. FACMITY INFORMATION <br /> �Faacility Contact: Norm Whitt cil,!1.1 Addteqs: 1941 E.Lo Stockton,CA <br /> - Date of Testin - June 17,2009 <br /> T F cil -- <br /> Date Local As2e!njc�yWwas�Notffled of Te May Phone: 209.483.0257- <br /> L282009, <br /> [Marhe of Local Agen5y inspector if present during teAng) <br /> 2TTSTTNG CTOR INFORMATION <br /> Com any Name., Stockton Service statioin!!��. <br /> Technician Conducting Test: Mike Jones <br /> Credentials: IX I CSL9 Licensed Contractor <br /> License Type: C-61/D40 HAZ/14TC I I SWRC8 Licensed Tank Tester <br /> License Number: 309105 <br /> Manufacturer TraininU <br /> g <br /> Mantifacturer Componep <br /> Date Trainin Expires <br /> 3. SUMMARY OF TEST RESULTS <br /> L (;oinpotlerit Pam Irall I Not Repairs Component 14 Not s <br /> F-kepair <br /> Tested Made Tested Madt <br /> Tank Anndifir Tegirig <br /> Seconda Pi oTtgthi VENTFstil X -----------------T—, <br /> PIYS-Wnp Testing X I <br /> - -- <br /> Spill/oveffln Cqbtikinme"t Boxes X- <br /> --j- <br /> If hydrostatic testing wos performed,describe what was done with the-water after completion of tests; <br /> PAGE 5 & 6 NIA. <br /> Secondary Pipe Vent Failed <br /> URTIFiCATION OF TECIINTCfAN RESPONSIBLE FOR CONX)UCTFNG TIFIS TESTING <br /> To the best of my knowledge,the facts stated it,this-document are accurate and in full compliance with legal requirements. <br /> Tecfthician'g Sigilaturc: 942LEe_Lqnes Date: June 17,2009 <br />