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TRI-ENNIAL SECONDARY CONTAINMENT TEST <br /> TEST DATE: June 7, 2012 <br /> 1. OWNER <br /> Name Quik Stop Markets, Inc. <br /> Address 4567 Enterprise Street, Fremont, CA 94538 Phone# 510-657-8500 <br /> Contact Michael Karvelot <br /> 2. FACILITY <br /> Name Quik Stop Market#152 <br /> Address 1721 S. Cherokee Lane#1, Lodi, CA 95240 Phone# 510-657-8500 <br /> Contact Michael Karvelot <br /> 3. CUPA <br /> Name San Joaquin County Environmental Health Notified May 30, 2012 <br /> Address 600 E. Main Street, Stockton, CA 95202 Phone# 209-468-8257 <br /> Contact Thuy Tran Fax# 209-468-3433 <br /> Inspector Present None <br /> 4. TESTING CONTRACTOR <br /> Name Walton Engineering, Inc. Lic# 617238 A, B, Haz <br /> Address P.O. Box 1025,West Sacramento, CA 95691 Phone# 916-373-1166 <br /> Contact Dulcinea Covan Fax# 916-373-1173 <br /> Test Technician Gerardo Guzman <br /> 5. SUMMARY OF TEST RESULTS <br /> Tank Annulars Tested 3 Containment Sumps Tested 3 <br /> Secondary Lines Tested 3 UDC's Tested 2 <br /> Component Results Component Results <br /> Annular-Tank#1 Gasoline-87 Pass Piping Sump#1 Gasoline-87 Pass <br /> Annular-Tank#2 Gasoline-89 Pass Piping Sump#2 Gasoline-89 Pass <br /> Annular-Tank#3 Gasoline-91 Pass Piping Sump#3 Gasoline-91 Pass <br /> Secondary Line#1 Gasoline-87 Pass U D C#1 Disp#1/2 Pass <br /> Secondary Line#2 Gasoline-89 Pass U D C#2 Disp#3/4 Pass <br /> Secondary Line#3 Gasoline-91 Pass <br /> I <br /> 6. COMMENTS <br /> Technician Signature —�' Date June 7, 2012 <br /> 0 2012 Walton Engineering,Inc. <br />