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Appendix VIII <br /> Underground Storage Tank <br /> Spill Container Testing Report Form <br /> TYPE OF ACTION FlInstallation ā¯‘Repair 012 Month <br /> 1. FACILITY INFORMATION <br /> CERS ID Test Date <br /> 10181263 12/16/2025 <br /> Facility Name <br /> Arco 6080 <br /> Facility Address City Zip Code <br /> 85 E. Louise Ave. Lathrop 95330 <br /> 2. SERVICE TECHNICIAN INFORMATION <br /> Company Performing the Test Phone <br /> Nwestco LLC 925-551-7444 <br /> Mailing Address <br /> 6B05 Sierra Court, Suite G, Dublin, CA 94568 <br /> Service Technician Performing Test <br /> Gabriel Solorio <br /> Contractor/Tank Tester License Number <br /> 1073967 <br /> ICC Number IC C Expiration Date <br /> 10425282 9/14/2026 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer and Test Equipment Training Certifications Expiration Date <br /> OPW UST EVR Phase 1 Tech cart #1193597 6/9/2027 <br /> 4. TEST PROCEDURE INFORMATION <br /> Test Procedures Used Components Tested <br /> 1 Hour Hydrostatic All Spill Buckets <br /> 5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br /> 1 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. 1 understand <br /> that test procedures shall be made available upon request by the governing authority. <br /> Service Technician Signature Date Total #of Pages <br /> 12/16/2025 2 <br /> CERS = California Environmentstl Reporting System, ID = Identification, iCC = International Code <br /> Council <br /> Page 1 of 2 <br />