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I UNDERGROUND STORAGE TANK SECONDARY CONTAINMENT TESTING REPORT FORM (Page 1 of 6) Type of Action ❑ Installation Test ❑ Repair Test ❑ Six Month Test ® 36 Month Test I . FACILITY INFORMATION CERS ID 712 te of Secondary Containment Test - 13 - 18 Business Name ( Same as Facility Name or DBA- Doing Business As ) BP Arco 02076 Business Site Address City ZIP Code 800 Kettleman Ln Lodi 95240 11 , UNDERGROUND STORAGE TANK SERVICE TECHNICIAN INFORMATION Name of UST Service Technician Performing the Test (Print as shown on the /CC Certification. ) Phone # Jarrod Cooke ( 209 ) 365 - 1246 Ext , 77 Contractor/Tank Tester License # ICC Certification # ICC Certification Expiration Date 743160 5311523 - UT 4-6- 19 III , SUMMARY OF SECONDARY CONTAINMENT TESTING RESULTS Tank ID : (By tank number, stored product, etc ) A T1 Regular B T2 Regular C T3 Regular ]NA D T4 Supreme Tank Containment Tightness Test Result ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ ® Pass El Fail ❑ NA Product Piping Containment Tightness Test Result ® Pass ❑ Fail ❑ NA Z Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA Communication Test Result ❑ Pass [IFail ® NA ElPass ElFail ® NA E] Pass [:1Fail ® NA ElPass ElFail E1 NA Remote Fill Piping Containment Tightness Test Result E] Pass [:1Fail E NA ❑ Pass ElFail ® NA ❑ Pass El Fail ® NA ❑ Pass ❑ Fail ® NA Communication Test Result E] pass ElFail ® NA ❑ Pass ElFail ® NA ElPass ElFail ® NA ❑ Pass 01 Fail ® NA Vent Piping Containment Tightness Test Result El Pass El Fail ® NA [I Pass El Fail ® NA ❑ Pass El Fail ® NA Pass ❑ Fail ® NA Communication Test Result ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail E) NA ❑ Pass ❑ Fail ® NA Vapor Recovery Piping Containment rA Tightness Test Result ElPass ElFail ® NA ElPass ElFail [ED NA ❑ Pass ElFail [D NA E] Pass ElFail ❑ NA Communication Test Result ❑ Pass ElFail ® NA E] pass ❑ Fail ® NA 171Pass ❑ Fail ® NA ❑ Pass E) Fail ® NA I Turbine I Product Piping Sump Tightness Test Result ® Pass El Fail El NA ® Pass 171 Fail El NA ® Pass [I Fail El NA Pass Fail ❑ NA Fill Riser Sump Tightness Test Result ® Pass ❑ Fail ElNA ® Pass 171Fail 171NA ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail E] NA Vent t Transition Sump ID : a b c d Tightness Test Result ElPass ElFail ® NA ❑ Pass ElFail 0 NA ElPass ElFail ® NA ❑ Pass ElFail [D NA UDC ID : 1 2 3 Tightness Test Result ® Pass ElFail 171NA ® Pass ElFail ❑ NA ® Pass ElFail ElNA E) Pass ❑ Fail ❑ NA UDC ID : 5 6 7 $ Tightness Test Result ® Pass ❑ Fail ❑ NA © Pass F1Fail ElNA ® Pass ElFail 171NA ® Pass ❑ Fail F1 NA I UDC ID : J 10 11 12 Tightness Test Result ❑ Pass E] Faii ❑ NA ❑ Pass El Fail E3 NA ❑ Pass ❑ Fail ❑ NA El Pass El Fail El NA All items marked "Fail" or "N/A " must be explained in their respective "COMMENTS " section . IV . CERTIFICATION BY UST SERVICE TECHNICIAN CONDUCTING THIS TESTING 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 Environmental Reporting System , ID = Identification , UST = Underground storage tank , ICC = International Code Council , NA = Not applicable, UDC = Under•dispenser containment