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ECEtr.-1\4� � <br /> ®GETTLER-RYAN INC. GR Job# 1820- 1786 <br /> JUL 13 2018 <br /> ",� 'pi"Tlcontma!nment <br /> SWRCB,January 2006 <br /> Spill Bucket Test�i�- fiThis form is intended for use by contractors performing annual - d structures. The Completed farm and <br /> printouts from tests (f applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. <br /> 1.FACILITY INFORMATION <br /> Facility Name: Arco 7148 Date of Testing: 09/19/2018 <br /> acilityAddress: 3400 N. MacArthur Tracy 95376 <br /> Facility Contact: DarV1 Lee Phone: 415-902-5089 <br /> Date Local Agency Was Notified of Testing: <br /> arae of LocalAgency inspector i present during testing): <br /> 2.TESTING CONTRACTOR INFORMATION <br /> Company Name: Gettler-Ryan Inc.,6805 Sierra Court,Suite G,Dublin,Ca.94568 Ph.#925-551-7555 <br /> Technician Conducting Test: David Rouse <br /> Credentials:(1) CSLB Contractor ICC service Tech. SWRCB Tank Tester Other(Specify) <br /> License Number: 220793 ICC Tech Number: <br /> 3.SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: llLdrostatic Vacuum Other <br /> Test Equipment Used: Standard Tape Measurer Equipment Resolution: 1/I6" <br /> Identify Spill Bucket(By Tank 1 2 3 4 <br /> Number,Stored Product,etc.) 91-vapor 87-vapor <br /> irect Bury <br /> Bucket Installation Type: irect Bury Lpirect Bury LjDirect Bury <br /> ontained in Sump QX Contained in Sump Elontained in Sump contained in Sump <br /> Bucket Diameter: 1011 1011 <br /> Bucket Depth: 10 1/2 10 1/2 <br /> Wait time between applying <br /> vacuum/water and start of test: lapass <br /> 5 mins 5 mins <br /> Test Start Time(Ti): 10 :15 10 : 15 <br /> Initial Reading(Ri): 911 got <br /> Test End Time(Tf): 11 :15 11: 15 <br /> Final Reading(Rf) 91� 9" <br /> Test duration(Tf-Ti): 1 hr 1 hr <br /> Change in Reading(Rf-Ri): 0 0 <br /> Pass/Fail Threshold or Criteria: 0 0 0 0 <br /> Test Results: Lzail Paas QF= QPass ail QPass sil <br /> Comments- include information on repairs made prior to testinjz,and recommendedfollow-up or failed tests <br /> CERTFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> I hereby certify that all the information contained int 's report is true,accurate,and in full compliance with legal requirements <br /> � / <br /> Technician's Signature: Date: 06/19/2018 <br /> (1) State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements <br /> may be more stringent. <br />