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SWRCB,January 2002 0 0 Page 1 of 1 <br /> .SPILL/OVERFILL CONTAINMENT BOXES <br /> Facility Name: Flying J#617 Date of Testing: 5/5/2011 <br /> Facility Address: 15100 Thorton Rd. Lodi,CA 95242 <br /> Facility Contact: Mannager Phone: <br /> Date Local Agency Was Notified of Testing: <br /> Name of Local Agency Inspector(ifpresent during testing): <br /> TESTING CONTRACTOR INFORMATION <br /> Company Name: Jones Covey Group,Inc. <br /> Technician Conducting Test: Robert Vargas <br /> Credentials: ❑ CSLB Licensed Contractor SWRCB Licensed Tank Tester <br /> License Type: License Number: <br /> Facility is Not Equipped With Spill/Overfill Containment Boxes ❑ <br /> Spill/Overfill Containment Boxes are Present,but were Not Tested ❑ <br /> Test Method Developed By: ❑ Spill Bucket Manufacturer ® Industry Standard ❑ Professional Engineer <br /> ❑ Other(Specify) <br /> Test M;Dia <br /> sed: ❑ Pressure ❑Vacuum ® Hydrostatic <br /> ❑ Other(Specify) <br /> Test Ent Used: Incon TS-STS Equipment Resolution: +/-0.0001 <br /> 1111111111111111111M Sol= <br /> Spill Box# T-1.Dsl Spill Box# T-2 Dsl Spill Box# T-3 Dsl Spill Box# T-4/91 <br /> Bucketer: 18" 18" 18" 18" <br /> Bucket Depth: 18" 18" 18" 18" <br /> Wait time between applying <br /> pressure/vacuum/water and 30Min 30Min 30Min 30Min <br /> starting test: <br /> Test Start Time: 3:51 4:48 8:33 8:50 9:13 9:44 2:35 2:53 <br /> Initial Reading(RI): 3.5188 3.5174 1.8704 1.8693 4.2363 4.2358 7.4705 7.470 <br /> Test End Time.. 4:06 5:03 8:48 9:05 9:28 9:59 2:50 3:08 <br /> Final Reading(RF): 3.5190 3.5171 1.8694 1.8690 4.2366 4.2350 7.4701 7.4702 <br /> Test Duration: 15min(each) 15min(each) 15min(each) 15min(each) <br /> Change in Reading(RF-RI): 0.0002 0.0003 0.0010 0.0003 0.0003 0.0008 0.0004 0.0001 <br /> Pass/Fail Threshold or 0.0020 0.0020 0.0020 0.0020 <br /> Criteria: <br /> Test Result: ® Pass ❑Fail K Pass ❑Fail IX Pass ❑Fail ® Pass ❑Fail <br /> Comments <br /> Spill Buckets passed hydrostatic test. <br /> Technician's Signature: `� � Date:5/5/2011 <br />