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RECEIVED BY EHD <br /> 7/18/2022 - during inspection Appendix VIII <br /> Underground Storage Tank <br /> Spill Container Testing Report Farm <br /> TYPE OF ACTION J Installation _ Repair 12 I'donth <br /> 1. FACILITY INFORMATION <br /> CERS ID Test Date <br /> CERS 10689070 07/06/2021 <br /> Facility Name <br /> Fed Ex Ground <br /> Facilitx Address City ZIP Code <br /> 120S Ha sen Road Tracy 95304 <br /> 2. SERVICE TECHNICIAN INFORMATION <br /> Company Performing the Test Phone <br /> Tanknology,Inc. 800-964-1250 <br /> Mailin�q Address <br /> 11000 N opac Expy#500 Austin,TX 78759 <br /> Service Technician Performing Test <br /> Clint Fuhrman <br /> Contractorgank Tester License Number <br /> 743160 <br /> ICC Number ICC Expiration Date <br /> 9160945 05/03/2023 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer and Test Equipment Training Certifications Expiration Date <br /> OPW:EVR Phase 1 05/05/2023 <br /> Tanknology Certification:Level III Secondary Containment Testing Certification Exam 05/22/2022 <br /> 4. TEST PROCEDURE INFORMATION <br /> Test Procedures Used Components Tester! <br /> HYDROSTATIC FILL SPILL BUCKETS <br /> 5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br /> I hereby terrify that each spilt container was rested in accordance with California Code of <br /> Regulations, rifle 23, division 3, chapter 96, section 2637.9; that required supporting <br /> documentation is arrached;and all information contained herein is accurate. l understand <br /> that test procedures shall be made available upon request by the governing authority. <br /> Service Technician Signature Date Total# of Pages <br /> 07/06/2021 2 <br /> CERS = California Environmental Reporting System, ID = Identification. ICC = International Code <br /> Council <br /> Page 1 of 2 <br />