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UNDERGROUND STORAGE TANK SECONDARY CONTAINMENT TESTING REPORT FORM (Page 1 of 6) TypofAion ❑ Installation Test ❑ Repair Test ❑ Six Month Test 0 36 Month Test I . FACILITY INFORMATION CERS ID Date of Secondary Containment Test 10181433 11 / 14/2019 Business Name (Same as Facility Name or DBA-Doing Business As) Unocal255886 Business Site Address City ZIP Code 2701 West March Lane I Stockton 95219 Il . UNDERGROUND STORAGE TANK SERVICE TECHNICIAN INFORMATION Name of UST Service Technician Performing the Test (Print as shown on the ICC Certification) Phone # Michael McCarter (707 ) 545-5522 Contractor / Tank Tester License # ICC Certification # ICC Certification Expiration Date Able Maintenance , Inc. - 312844 8819839 10/15/2021 III . SUMMARY OF SECONDARY CONTAINMENT TESTING RESULTS TANK ID : (By tank number, stored product, etc.) A 87 B 91 C Diesel D Tank Containment Tightness Test Result 0 Pass ❑ Fail ❑ NA 0 Pass ❑ Fail ❑ NA 0 Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA Product Piping Containment Tightness Test Result 0 Pass ❑ Fail ❑ NA 0 Pass ❑ Fail ❑ NA 0 Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA Communication Test Result 0 Pass ❑ Fail ❑ NA 0 Pass ❑ Fail ❑ NA 0 Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA Remote Fill Piping Containment Tightness Test Result ❑ Pass ❑ Fail 0 NA p Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail ❑ NA Communication Test Result ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail [INA Vent Piping Containment Tightness Test Result ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail ❑ NA Communication Test Result ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail ❑ NA Vapor Recovery Piping Containment Tightness Test Result ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail ❑ NA Communication Test Result ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail ❑ NA Turbine / Product Piping Sump Tightness Test Result 0 Pass ❑ Fail ❑ NA 0 Pass ❑ Fail ❑ NA 0 Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA I Fill Riser Sump Tightness Test Result ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail ❑ NA VENT / TRANSITION SUMP ID: a b C d i Tightness Test Result ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail 0 NA ❑ Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA UDC ID : 1 UDC 1 /2 2 UDC 3/4 3 UDC 5/6 4 UDC 7/8 Tightness Test Result 0 Pass ❑ Fail ❑ NA 0 Pass ❑ Fail ❑ NA 0 Pass ❑ Fail ❑ NA 0 Pass ❑ Fail ❑ NA UDC ID : 5 UDC 9/10 6 UDC 11 /12 7 8 Tightness Test Result 0 Pass ❑ Fail ❑ NA 0 Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA UDC ID : 9 10 11 12 Tightness Test Result ❑ Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail [INA ❑ Pass ❑ Fail ❑ NA ❑ Pass ❑ Fall ❑ NA All items marked "Fail" or "NA " must be explained in their respective "COMMENTS" section. ' , 1V. CERTIFICATION BY UST SERVICE TECHNICIAN CONDO INGV L LJ I hereby certify that the secondary containment was tested in accordance with California Code of Regulations , Title 23, Division 3 , Chapter 16, Section 2637 and all the information contained herein is accurate. UST Service Technician Signature �. CERS = California Envna �ironmental Reporting System, ID = Identification, UST = Underground Storage Tank, ICC = IntematIun ' �=mot 46i le; - Urrder- Dispenser Containment D E P1It R I IAliENT