Laserfiche WebLink
Page I of 2 <br />All Your SB989 Needs: (951) 681-0708 RE -TEST <br />1. FAC MITYMMM&L <br />..ION <br />Facility <br />Facility Name: United Western Grocers Date of Testing: 02/01/2006 <br />Facility Address: 1990 Piccoli Rd., Stockton CA. <br />Facility Contact: Pat Guillermety (626) 458-3559 <br />Date Local Agency Was Notified of Testing: 01/25/2006 <br />Name of Local Agency Inspector (#'present during testing): Willy Ng, SR. R.E.H.S. <br />2. RE -TESTING CONTRACTOR INFORMATION <br />Company Name: A & J Environmental Service's Inc. <br />Technician Conducting Test: Jason Cosby <br />Credentials: X CSLB Licensed Contractor <br />0 SWRCB Licensed Tank Tester <br />License Type: A-Haz <br />Manufacturer <br />License Number: 653381 <br />Manufacturer Training <br />Component(s) Date Training Ex2ires <br />Intelligent Controls <br />IN -CON TS -STS V2.02 2007 <br />IL IL 1. - I FLUMM <br />Component <br />,, 10M <br />Component <br />■M® <br />Dispenser Contairanent Box <br />If hydrostatic testing was performed, describe what was done with the water after completion of tests: <br />Water Was Hauled ALALaj With Testing Company To Be Re -Used For Future Testing <br />CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br />To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements <br />Technician's Signature: Date: h --v, <br />L) <br />