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APR-30-2010 FRI 05: 25 PM P. 007 <br /> Page 2 of 14 <br /> Swondwy Containment Twdng Report Form <br /> ThiStmisotendedibrLmbym&adompmbmftpWockbftofUSTsmndwycordainmntWgem, Use the WfViaft pages of <br /> this form to report rvsA for all conwrierft t . The tem form,wrliten test procedures,and printouts from tests(d ),shotes <br /> be prWded to the fedW owmr1qpwW for submittal to the local reg <br /> 4. FACILITY INFORMATION <br /> Faci>' Name: Truff Truck Ste Date of Testing: 1116/2009 <br /> Fack Addrew 3940 N.Tracy alvd.Tracy, CA 95304 <br /> Facility Con= Debbie Phone: 209-832-5006 <br /> Date Local Nua Was Notified of T 01/14/2009 <br /> Name of Local Agency Inspector(If ): N/A <br /> 5. TESTING CONTRACTOR,-INFORMAXION <br /> Campany Name. EPIC Compliance Systems <br /> Technician Conducfin2 Test Ketch Huston <br /> Credentlels: Q CSL8 Ucenad Conttecior ' SWRC5 Lic erw!Tank Tester <br /> Umn Type: A Umnse Num 880430 <br /> ter Ttatninst <br /> m s Date Trainin <br /> Caldwell Caldwell Level Indicator N/A <br /> 6. SUMMARY OF TEST RESULTS <br /> Hent Pan Fan Nat Tested S Repairs Com t Pass Fail Not Tested R r3 <br /> Made <br /> UDC 15-16a ® ❑ <br /> UDC 15-17a D ❑ Q ❑ <br /> LDDC 17-18a ® ® ❑ ® O ❑ ❑ <br /> ❑ 13 = u <br /> 13 Q a u o <br /> ❑ Q 4 a ❑ <br /> ❑ o ® ® <br /> 13 <br /> o ❑ ❑ ❑ ❑ <br /> ❑ ❑ 4 ❑ <br /> K MOM aft was:garkmied.describe what was done with the wow after completion of <br /> Filtered back into 500 gal wafter trailer. <br /> CERTIFICATION OF TECHNICIAN RLSPONS13LE FOR CONDUCTING THIS TESTING <br /> To Me best of my knowkdge,the facts stated in this document ars accwate and in full compliance with ko requinwdents <br /> Technician's 5lgnaouns' Date, 1/16/O9 <br /> SZ/E9 39Vd AYH >CnH:3 EZSCS6EY99 ge;®t Qt9Z/ZZ/b0 <br />