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Appendix Vill <br /> Underground Storage Tank <br /> Spill Container Testing Report Farm <br /> TYPE OF ACTION ® Installation ❑ Repair ❑ 12 Month <br /> 1. FACILITY INFORMATION <br /> CERS ID Certification Date <br /> 03/04/2024 <br /> Facility Name <br /> MCM14 Corp - Arco <br /> Facility Address City County Zip Code <br /> 130 S. Wilson Way Stockton San Joaquin 95205 <br /> 2. SERVICE TECHNICIAN INFORMATION <br /> Company Performing the Certification Phone <br /> Elite IV Contractors 209 461-6337 <br /> Mailing Address <br /> 2535 Wigwam Dr Stockton CA <br /> Contractor/Tank Tester License <br /> Number 1001331 <br /> Service Technician Performing Test <br /> Benjamin Malaspina <br /> ICC Number ICC Expiration Date <br /> 9519380 06/17/2024 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer& Test Equipment Training Certifications Expiration Date <br /> OPW Phase 1 UST 0182799 06/30/2025 <br /> 4. TEST PROCEDURE INFORMATION' <br /> Test Procedures Used Component(s) Tested <br /> Hydrostatic 87 Main Tank Spill Container <br /> 5. CERTIFICATION BYTHE SERVICE TECHNICIAN CONDUCTING THE TEST <br /> I hereby certify that each spill container was tested in accordance with Calitbrum Code of <br /> Regulations, tide 23, division 3, chapter 16, section 26371,that required supporting documentation <br /> is attached and all information contained herein is accuratel understand that testp►ocedures shall <br /> be made avallable upon request by the goveming authority. <br /> Service Technician Signature Date Total #of Pages <br /> 03/04/2024 z <br /> CIN RS= California Environmental Reporting System, GPH= Gallons Per Hour, ICS= Identification, [CC= <br /> International Code Council <br />