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SWRCB,January 2006 <br /> SPILL BUCKET TESTING REPORT FORM <br /> This form is intetuled for use by cotrtractots peiforining amrual testi)rg oJ'UST spill contaiumew sU•trctures. The completed form mrd pri)No:rl,ft•om <br /> tests(if applicable),should be provided to the facility ownet/operator.frr submittal to the local regulatory agency. I <br /> 1.FACILITY INFORMATION <br /> Facility Name:BP Arco Date of Testing: 10/03/2008 <br /> Facility Address: 1617 W FREMONT,STOCKTON CA 952032038 <br /> Facility Contact: lFacility Phone:209-462-1617 <br /> Date Local Agency Was Notified of Testing:09/29/2008 <br /> Name of Local Agency Inspector if present during testing):Ray Von Flue <br /> 2.TESTING CONTRACTOR INFORMATION <br /> Company Name:TAIT ENVIRONMENTAL SERVICES <br /> Technician Conducting Test:Dra an Pesic <br /> Credentials: ®CSLB Contractor ®ICC Service Tech ❑SWRCB Tank ❑Other(Specify) <br /> Tester <br /> License Number(s):A ASB HAZE C-10. 588098: 5240928-UT <br /> 3.SPILL BUCKET TESTING INFORMATION <br /> Test Method Used ®Hydrostatic ❑Vacuum ❑Other <br /> Test Equipment Used:Tape/Paint Marker -]Equipment Resolution: 1/16" <br /> Identify Spill Bucket(By Tank Nmnber, 191 Fill 2 91 Vapor 3 4 <br /> Stored Product,etc) 1' <br /> Bucket Installation Type []Direct Bury ❑Direct Bury ❑Direct Bury ❑Direct Bury <br /> ®Contained in Sump ®Contained in Sump E]Contained in Sump El Contained in Sump <br /> Bucket Diameter inches 1 I I 1 <br /> Bucket Depth inches 15 14 <br /> Wait Time between applying 15 min 15 min <br /> vacuum/water and start of test <br /> Test Start Time: 9:30 9:30 <br /> Initial Reading Ri): 101/4 10 <br /> Test End Time: 10:30 10:30 <br /> Final Reading(Rf): 101/4 I0 <br /> Test Duration: 1 hour I hour <br /> Chan e in Reading Rf-Ri : 0 0 <br /> Pass/Fail Threshold or Criteria: 0 0 <br /> Test Result Pass Pass <br /> Comments:Test water left in existing 55 gallon drum. <br /> € <br /> i <br /> CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> I hereby certify that all the information coffMined in this report is true,accurate and in full compliance with legal requirements <br /> Technician's SignatureL �1-1� Date 10/03/2008 <br />