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944C11 006 <br />Spill Bucket Testing Report Forglt <br />Thiy furm is intended for use by contractors performing of testitis of UST spill containment ,structures � n �' <br />,printouts from lesis (if applicable), should be provided to the facility ownWoperator for submidtral to the d <br />L NA,f6l1.4TT .LN1' JKMAT)«JPI <br />Faeili Name: Hummer Lane Oil I Date of Testing: 06/20/2014 <br />Facility Address: 3304 W. Hammer lane, Stockton, Ca. 95619 <br />Faciliry Contact: Mice <br />Vate Local Agency Was Notified <br />Name of Local A.eenev Inspector <br />(209)478-9293 <br />�.�mi <br />. r fr am <br />CoH Taut' Warne: Reliable Petroleum Services, Inc. <br />Technician Conducting Test Guadalupe Saacbea <br />Credentials`: x CSLB Contmct0r x LCC Servicc Tech. U SWRCB Tank'I'ester fi other (Specify) <br />License Number(s): 883706 5250451 -UT <br />I VVINT *9 RTMIWIG-r'r cmrsrr- wamd,%n%M d mv^vLF <br />Test N1etEtod Used: <br />xl4ydrostatie - ---- <br />fl Vacuum _ <br />U Odd <br />Test uigment Used: Standard Tape Measure <br />Eguipmenf Resolution:NlA <br />:M <br />� <br />Identify Spill B"icdcet (&y Tank <br />Num her, Stored Pro!h c4 eta <br />I Tl: 87 Fill <br />2 T2:91 Fill <br />3 T3: Diesel Fill 4 'lt"4; <br />Bucket Installation Type: <br />x Direct Bury <br />0 Contained in Sump <br />x Dhva Bury <br />0 Contained in Sump <br />12" <br />x Direct Bury Direct <br />0 Contained in Sump I I Contained in Saute <br />12" <br />Bucket Diameter: 12" <br />Bucket Depth: <br />12'/4 " <br />12" <br />14" <br />Wait time between applying <br />vacuunVweter and start of test: <br />1 mimic <br />_ <br />1 misuse <br />1 minute <br />Teck Start Time (T,): <br />9:29 am. <br />9:29 am. <br />9:29 am. <br />initial Reading (R'): <br />11 '/a" <br />IV, <br />12 7/9" <br />'r'est End Time (Tv): <br />10:29 am <br />10:29 a.m. <br />10:29 a.m. <br />Final treading (RF): <br />11 /;' <br />11°' <br />12 7/8" <br />Test Duration (TF — TI): <br />I br <br />_ tdr <br />i hr — — <br />Change in Reading (Ry - Ro): <br />0 1 <br />0 <br />1!16" <br />_ 0 — <br />1/16" <br />PasstFail Thresbold or <br />Criteria 1116" <br />Tit Resvlt: <br />x iQasS 0 ;Fait <br />x Pass 0 Fall <br />x Pass 0 Fail pass p Fail <br />w.. vvaaapill Wo — lenccuae a ormaIron nn repairs maile prior to tesrft recomrnended foEduew-up for failed tests] <br />CERMCATION OF TECIMIC1AN RESPONSIBLE FOR CONDUCTING TIES TESTINC <br />Ila certify ri:at all the infenaatlon conre teed int tats report & true, stearate, and in fuel co�nt�rac¢ wit7a le al requirements. <br />Teelmician's Date 06/20/2014 <br />` State laws and regulations do not currently require testing to be po ormed by a qualified contractor. However, local requirements <br />may be more stringent. <br />b 6'd f 9689V960Z wnaloaled ®IgElle2j aZg:got 19 L Inf <br />