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SWRCB,January 2006 Spill Bucket Testing Report Form This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name:YRC#813 1 Date of Testing: 2/14/2024 Facility Address: 1535 East Pescadero Avenue,Tracy,Ca,95304 Facility Contact: Phone: Date Local Agency Was Notified of Testing : Name of Local Agency Inspector(fpresent during testing): Paul NSO 2. TESTING CONTRACTOR INFORMATION Company Name:Confidence UST Services, Inc. Technician Conducting Test:Michael Stromecki Credentials': 0 CSLB Contractor ❑I ICC Service Tech. ❑SWRCB Tank Tester Other(Spec) License Number(s): 1073977 8339168 3. SPILL BUCKET TESTING INFORMATION Test Method Used: ❑✓Hydrostatic ❑Vacuum ❑Other Test Equipment Used:Ruler Equipment Resolution:1/16" Identify Spill Bucket(By Tank 1Waste Oil Near Rack 2 Waste Oil Near Gate 3 Anti-Freeze 4 Gear Oil Number, Stored Product, etc.) Bucket Installation Type: 0 Direct Bury ❑Direct Bury 0 Direct Bury 0 Direct Bury ❑Contained in Sump 0 Contained in Sump ❑Contained in Sum ❑Contained in Sum Bucket Diameter: 13 12 13 13 Bucket Depth: 191/2 16 203/4 21 Wait time between applying 5 Min 5 Min 5 Min 5 Min vacuum/water and start of test: Test Start Time(TI): 9:32 AM 9:27 AM 9:18 AM 9:18 AM Initial Reading(Rj): 19 3/8" 15 3/8" 18 7/16" 18 11/16" Test End Time(TF): 10:32 AM 10:27 AM 10:18 AM 10:18 AM Final Reading(RF): 19 3/8" 15 3/8" 18 7/16" 18 11/161, Test Duration(TF—Ti): 60 Min 60 Min 60 Min 60 Min Change in Reading(RF-RI): 0" 0" 0" 0" Pass/Fail Threshold or 1/8" 1/8" 1/8" 1/8" Criteria: Test Result: 0 Pass ❑Fail 0 Pass ❑Fail 0 Pass ❑Fail 0 Pass ❑Fail Comments— (include information on repairs made prior to testing, and recommended follow-up for failed tests) No repairs required. CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report is true,accurate,and in full compliance with legal requirements. Technician's Signature: Date: 2/14/2024 ' State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements may be more stringent.