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CERS = California Environmental Reporting System, ID = Identification, ICC = International Code <br />Council <br />Page 1 of 2 <br />TYPE OF ACTION Installation Repair 12 Month <br />1. FACILITY INFORMATION <br />CERS ID <br />10181557 <br />Test Date <br />11-26-24 <br />Facility Name <br />Valley Pacific Petroleum <br />Facility Address <br />1501 W Charter Way <br />City <br />Stockton <br />ZIP Code <br />95206 <br />2. SERVICE TECHNICIAN INFORMATION <br />Company Performing the Test <br />CGRS, Inc. <br />Phone <br />(916) 991-1100 <br />Mailing Address <br />5444 Dry Creek Road; Sacramento, CA. 95838 <br />Service Technician Performing Test <br />Garrett Warren <br />Contractor/Tank Tester License Number <br />CSLB#803616 <br />ICC Number <br />8185019 <br />ICC Expiration Date <br />10-18-26 <br />3. TRAINING AND CERTIFICATIONS <br />Manufacturer and Test Equipment Training Certifications Expiration Date <br />OPW UST EVR Phase 1 Cert. #101018 5-27-25 <br />Franklin Fueling Phase 1 EVR UST Cert.#1000553709 11-24-25 <br />4. TEST PROCEDURE INFORMATION <br />Test Procedures Used Components Tested <br />RP-Spill Containers <br />5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br />I hereby certify that each spill container was tested in accordance with California Code of <br />Regulations, title 23, division 3, chapter 16, section 2637.1; that required supporting <br />documentation is attached; and all information contained herein is accurate. I understand <br />that test procedures shall be made available upon request by the governing authority. <br />Service Technician Signature <br />Garrett Warren <br />Date <br />11-26-24 <br />Total # of Pages <br />2