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So Bucket Testing Report Fono <br /> This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and printouts <br /> from tests(if applicable),should be provided to the facility owner/operator for submittal to the local regulatory agency. <br /> 1. FACILITY INFORMATION CLLC: SKTNCAII GEO PAR: UE-046 <br /> Facility Name: AT&T/SBC I Date of Testing: 7/18/06 <br /> Facility Address: 907 LINCOLN ROAD, STOCKTON <br /> Facility Contact: TOM WILLIAMS Phone: 209-466-1010 <br /> Date Local Agency Was Notified of Testing: 48 HOURS PRIOR(MIN) <br /> [Name of Local Agency Inspector(if present during testing): SAN JOAQUIN ENVIRONMENTAL HEALTH <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company Name: TAIT ENVIRONMENTAL SYSTEMS <br /> Technician Conducting Test: MICHAEL L. STRAWN,II <br /> Credentials: ®CSLB Contractor ®ICC Service Tech. ❑SWRCB Tank Tester ❑Other(Spec) <br /> License Number(s): A B ASB C-10 HAZ License Number: 588098 <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: ®Hydrostatic ❑Vacuum ❑Other <br /> Test Equipment Used: VISUAL/MEASURE Equipment Resolution: <br /> x,>%i.K .i �,a,r:.•r; .. +' c.... .,q..Y r. .>ka�;v /-nJ; i,i,:,ti 3T ..9>S..mk'... .(/.i ,:...;a..< yi., ..: ,e.. :""..... .... n�'ry//..x "rtira( -A-°'.��DeHey,c'^' <br /> Identify Spill Bucket(By Tank 1 TANK #1171 2 3 4 <br /> Number, Stored Product, DIESEL FILL <br /> etc.) BUCKET <br /> Bucket Installation Type: ❑Direct Bury ❑Direct Bury ❑Direct Bury ❑Direct Bury <br /> ® Contained in Sump ❑Contained in Sump ❑Contained in Su ❑Contained in Sum <br /> Bucket Diameter: 11" <br /> Bucket Depth: 10" <br /> Wait time between applying 15 MINUTES <br /> vacuum/water and start of test: <br /> Test Start Time(Ti): 2:15 P.M. <br /> Initial Reading(Rj): 9.5" <br /> Test End Time(TF): 3:15 P.M. <br /> Final Reading(RF): 9.5" <br /> Test Duration(TF—Tj): 1 HOUR <br /> Change in Reading(RF-Rj): 0" <br /> Pass/Fail Threshold or .002" <br /> Criteria: <br /> Test Result: ® Pass ❑Fail 0 Pass ❑Fail ❑ Pass ❑Fail ❑ Pass 0 Fail <br /> Comments—(include information on repairs made prior to testing, and recommended follow-u for failed tests) <br /> *All hazardous test water was re-contained in (1) S gallon steel drum. Drum is labeled non-haz and is <br /> Read or ick-up. <br /> *Diesel Spill Bucket passed test. No repairs are needed at present time. <br /> CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> I hereby certify that all the information contained in this report is true,accurate,and in full compliance with legal requirements. <br /> Technician's Signatur Date: 7/18/06 <br />