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RECENCID <br /> JUS4 2011 <br /> ENVl E <br /> E <br /> P fM <br /> Secondarytai t Testing Report <br /> 1. FACIELM INFORMATION <br /> Facility Name: S d e,. 1 17 s . Date of Testing: 12 <br /> Facility Address: ,� ,� il, , . <br /> Facility Contact: Phone: <br /> Date Local Agency Was Notified of Testing: <br /> Namcal Agency Inspector(if present during testing): <br /> 2. TESTING CONTRACTOR O TION <br /> Company N e: Accu-Test Aiello <br /> Technician Conducting T Michael Aiello <br /> Credentials: 19 CSLE Licensed Contractor ❑SWRCB Licensed Tank Tester <br /> License Type: 854172 License Number: <br /> Manufacturer Training <br /> Manufacturer Component(s) Date Training Expires <br /> VM1 Barrett Sump Tester 6/1113 <br /> 3. SUMMARY OF TEST RESULTS <br /> Component Pass Fail Not Repairs Component Pass Fail Not Repairs <br /> Tested Made Tested Made <br /> IJ, t,, ❑ ❑ K ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑' ❑ ❑ ❑ ❑ <br /> It ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> 1f0AF- ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ 1 ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ 1 ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ 1 ❑ ❑ ❑ ❑ ❑ <br /> If hydrostatic testing was performed,describe what was done with the water after completion of tests: Water Was Processed. <br /> CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> To the bat of my knowledge,tkefacts stated in this document are accurate and in compliance with legal requirements <br /> Technician's Si Date: `; —� <br />