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Appendix 6 <br /> Underground Storage Tank <br /> Spill Containment Testing Report Form <br /> TESTING TYPE ❑ Installation ❑ Repair p 12 Month <br /> 1. FACILITY INFORMATION <br /> CERS ID Test Date <br /> 10181579 01/23/2026 <br /> Facility Name <br /> TRACY U.S.D <br /> Facility Address City ZIP Code <br /> 1975 W. LOWELL AVE TRACY 95376 <br /> 2. SERVICE TECHNICIAN INFORMATION <br /> Company Performing Testing Phone <br /> ECO-CHEK Compliance Inc 888-500-2435 <br /> Mailing Address <br /> P.O. Box 1394, Lafayette Ca 94549 <br /> Service Technician Performing Testing <br /> Ed Stearns <br /> Contractor License Number <br /> 14-1760 Ex. 9/30/2028 <br /> ICC Certification ICC Expiration Date <br /> 8883080-UT 11/6/2026 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer and Test Equipment Training Certifications Training Expiration Date <br /> Franklin Fueling - EBW & Phil Tite #1009893708 01/23/2028 <br /> OPW #104-635 3/11/2026 <br /> CNI #5271 2/04/2027 <br /> 4. TEST PROCEDURE INFORMATION <br /> Test Procedures Used Components Tested <br /> INDUSTRY STANDARD SPILL BUCKET'S <br /> 5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br /> I hereby certify that each spill containment was tested in accordance with California Code of <br /> Regulations, title 23, division 3, chapter 16, section 2664; that required supporting <br /> documentation is attached, and all information contained herein is accurate. I understand <br /> that test procedures must be made available upon request by the governing authorit . <br /> Service Technician Signature + Date Total # of Pages <br /> ��-�--- <br /> 01 /23/2026 2 <br /> CERS = California Environmental Reporting System, ICC = International Code Council, <br /> ID = Identification <br /> Page 1 of 2 <br />