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CERS = California Environmental Reporting System, ID = Identification, ICC = International Code <br />Council <br />Page 12 of 14 <br />TYPE OF ACTION Installation Repair 12 Month <br />1. FACILITY INFORMATION <br />CERS ID <br />10181479 <br />Test Date <br />2025-08-26 <br />Facility Name <br />Mid City Ca FO Regen <br />Facility Address <br />13850 Devries Road <br />City <br />Lodi <br />ZIP Code <br />95242 <br />2. SERVICE TECHNICIAN INFORMATION <br />Company Performing the Test <br />SunWest Engineering Constructors, Inc <br />Phone <br />(888) 588-8737 <br />Mailing Address <br />4780 Cheyenne Way, Chino, CA 91710 <br />Service Technician Performing Test <br />Izik Zamudio <br />Contractor/Tank Tester License Number <br />703190 <br />ICC Number <br />10230278 <br />ICC Expiration Date <br />2027-02-14 <br />3. TRAINING AND CERTIFICATIONS <br />Manufacturer and Test Equipment Training Certifications Expiration Date <br />FFS - FFS EVR Phase I Systems - VR-101 2027-05-03 <br />4. TEST PROCEDURE INFORMATION <br />Test Procedures Used Components Tested <br />EBW Spill Bucket <br />5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING <br />I 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. I understand <br />that test procedures shall be made available upon request by the governing authority. <br />Service Technician Signature Date <br />2025-08-26 <br />Total # of Pages <br />2 <br />6. SPILL CONTAINER DETAILS <br />SA-54302