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Appendix 8 <br />Underground Storage Tank <br />Secondary Containment Testing Report Form <br />TESTING TYPE ❑ Installation ❑ Repair x 36 Month <br />1. FACILITY INFORMATION <br />CERS ID <br />10180661 <br />1/6/2026 <br />One Stop Market <br />1151 W Louise Avenue <br />Manteca <br />95336 <br />2. SERVICE TECHNICIAN INFORMATION <br />Company Performing Testing: <br />Duncan Compliance: Dba, R&D Compliance Testing <br />(707) 621-0378 <br />Mailing Address: <br />P. O. Box 1503 Ukiah, CA 95482 <br />Service Technician Performing Testing: <br />Benjamin Duncan <br />Contractor License Number: <br />1036490 <br />ICC Certification: <br />5246802 -UT <br />ICC Expiration Date: <br />1/30/2027 <br />3. TRAINING AND CERTIFICATIONS <br />Manufacturerand Test Equipment Training Certifications <br />Training Expiration Date <br />Caldwell Level Change Indicator <br />6/23/28 <br />PEI Certificate of Completion -PEI Service Technician <br />5/4/27-5/6/27 <br />Franklin Fueling Systems -Pro Compliance Testing <br />5/23/27 <br />XERXES Corporation -Modern Welding Company -Western Fiberglass, Inc <br />4/5/27-4/12/27-5/3/27 <br />4. TEST PROCEDURE INFORMATION <br />Test Procedures Used <br />Components Tested <br />Vacuum <br />Tank Secondary Containment <br />Pressure <br />Piping Secondary Containment <br />Hydrostatic <br />Piping Sumps <br />Hydrostati <br />IDispenserSumps <br />5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br />I hereby certify that the secondary containment was tested in accordance with California <br />Code of Regulations, title 23, division 3, chapter 16, section 2666; 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 authority. <br />Service Technician Signature <br />,W 'o <br />1/6/2026 <br />Total # of pages <br />4 <br />CERS = California Environmental Reporting System, ICC = International Code Council, <br />ID = Identification, NA = Not Applicable, UDC = Under -Dispenser Containment <br />Page 1 of 4 <br />