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SWRCB,January 2006 <br /> SPILL BUCKET TESTING REPORT FORM <br /> This form is intended for use by contractors performing annual testing of UST spill containment structures.The completed form and printout from <br /> tests(if applicable),should be provided to the facility owner/operator for submittal to the local regulatory agency. - <br /> 1.FACILITY INFORMATION <br /> Facility Name:BP Arco JDate,of Testing: 10/16/2008 <br /> Facility Address: 1617 W FREMONT STOCKTON CA 952032038 <br /> Facility Contact: Facility Phone:209-462-1617 <br /> Date Local Agency Was Notified of Testing: 10/13/2008 <br /> Name of Local Agency Inspector if present during testing):None <br /> 2.TESTING CONTRACTOR INFORMATION <br /> Company Name:TAIT ENVIRONMENTAL SERVICES <br /> Technician Conducting Test: S.Graham <br /> Credentials: ®CSLB Contractor ®ICC Service Tech ❑SWRCB Tank ❑OtherS ec'p �) <br /> Tester <br /> License Number(s):A ASB HAZB C-10. 588098-.-5240926-UT <br /> 3.SPILL BUCKET TESTING INFORMATION <br /> Test Method Used ®Hydrostatic ❑Vacuum ❑Other <br /> Test Equipment Used:Marker&Tae E ui ment Resolution: 1/16 <br /> Identify Spill Bucket(By Tank Number, 1 Unl.87 Fill 2 Unl.87 Vapor 3 4 <br /> Stored Product,etc) <br /> Bucket Installation Type ❑Direct Bury ❑Direct Bury ❑Direct Bury ❑Direct Bury <br /> ®Contained in Sump ®Contained in Sump El Contained in Sump ❑Contained in Sump <br /> Bucket Diameter inches 12.5 12.5 <br /> Bucket Depth inches 15 15.5 <br /> Wait Time between applying 15 min 15 min <br /> vacuum/water and start of test <br /> Test Start Time: 9:00 9:00 <br /> Initial Reading 13.5 14 <br /> Test End Time: 10:00 10:00 <br /> Final Reading(Rf): 13.5 14 <br /> Test Duration: I hour I hour <br /> Chane in Reading Rf-Ri : 0 0 <br /> Pass/Fail Threshold or Criteria: 0 0 <br /> Test Result Pass Pass <br /> Comments:All water left on site in existing 55 gal.drum. <br /> CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> I hereby certify that all the information coutrained i is report is true,accurate and in full compliance with legal requirements — <br /> Technician's Signature Date 10/16/2008 <br />