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Appendix 6 <br /> Underground Storage Tans <br /> Spill Containment Testing Report Forth <br /> TESTING TYPE ❑ Installa#ion ❑ Repair Z 12 Month <br /> 1. FACILITY INFORMATION <br /> CERS ID Test Date <br /> 10181653 1/05/2026 <br /> Facility Name <br /> CHEVRON 201761 <br /> Facility Address City ZIP Code <br /> 1103 S. MAIN ST. PERMIT NUMB. N-3315 MANTECA 95337 <br /> 2. SERVICE TECHNICIAN INFORMATION <br /> Company Performing Testing Phone <br /> anknology,Inc. 800-964-1250 <br /> Mailing Address <br /> 11000 N Mopac Expy#500 Austin,TX 78759 <br /> Service Technician Performing Testing <br /> Jesus Saldivar <br /> Contractor License Number <br /> 743160 <br /> ICC Certification [CC Expiration date <br /> 8361393 105/12/2027 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer and Test Equipment Training Certifications Training Expiration Date <br /> OPW:EVR Phase 1 01/07/2027 <br /> 4. TEST PROCEDURE INFORMATION <br /> Test Procedures Used Components Tested <br /> VACUUM TEST SPILL BUCKETS <br /> 5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br /> I hereby certify that each spill containment was rested 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. l understand <br /> that test procedures must be made available upon request by the governing author4K-_ <br /> Service Technician Signature Date Total # of Pages <br /> d/ 01/05/2026 2 <br /> CERS = California Environmental Reporting System, ICC = International Cade Council; <br /> ID = Identification <br /> Page 1 of 2 <br />