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Appendix 6 <br /> Underground Storage Tank <br /> Spill Containment Testing Report Form <br /> TESTING TYPE. ❑ Installation ❑ Repair ❑ 12 Month <br /> 1. FACILITY INFORMATION <br /> CERS ID Test Date <br /> 10182111 02/24/26 <br /> Facility Name <br /> El Dorado Food Mart <br /> Facility Address City ZIP Code <br /> 2320 N. El Dorado St. Stockton 95204 <br /> 2. SERVICE TECHNICIAN INFORMATION <br /> Company Performing Testing Phone <br /> Alltech Petro, Inc. (209) 559-1616 <br /> Mailing Address <br /> P.O. Box 4208, Sonora Ca, 95370 <br /> Service Technician Performing Testing <br /> Isaac Anderson <br /> Contractor License Number <br /> 1093213 <br /> ICC Certification ICC Expiration Date <br /> 8146912 10/16/26 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer and Test Equipment Training Certifications Training Expiration Date <br /> OPW #100456 04/22/26 <br /> 4. TEST PROCEDURE INFORMATION <br /> Test Procedures Used Components Tested <br /> Manufacturer/PEI RP-1200 Unleaded 87, Unleaded 91 & Diesel Spill Buckets <br /> 5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br /> 1 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. / understand <br /> that test procedures must be made availa upon request by the governing authority. <br /> Service Technician Signatur _ Date Total # of Pages <br /> 2/24/26 2 <br /> CERS = California Environmen Reporting System, ICC = International Code Council, ID = <br /> Identification <br /> Page 1 of 2 <br />