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SWRCB,January 2006 <br /> Spill Bucket Testing Report Form MAR 16 2016 <br /> This form is intended for use by contractors performing annual testing of(IST spill containment stru gq.O - /�p'rd <br /> printouisfrom tests(iit'applicable), should be provided to thefacility owner/operatorfor submittal tol�lilCI ' �` <br /> 1. FACILITY INFORMATION <br /> Facility Name: A.G SPANOS JET CENTER I Date of Testing: 2-22-16 <br /> Facility Address: 4800 S AIRPORT WAY STOCKTON CA <br /> Facility Contact: THOMAS Phone: 209-982-1550 <br /> Date Local Agency Was Notified of Testing:1-20-16 <br /> Name of Local Agency Inspector(if present during testing): STACY <br /> 2.TESTING CONTRACTOR INFORMATION <br /> Company Name: AFFORDA TEST. 416 2nd Street Galt,CA 95632 (209)744-0112 Fax:(209)744-0116 <br /> Technician Conducting Test: ❑Lyle D.Nimmo ❑ Zane A.Nimmo ® David A.Winkler ❑ Felix G.Ramirez <br /> 5249115-UT 5263322-UT 5263373-UT 5273934-UT <br /> Credentials': ®ICC Service Tech. ®SWRCB Tank Tester <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: ®Hydrostatic ❑Vacuum ❑ Other <br /> Test Equipment Used: h20 and tape measure Equipment Resolution: 1/16 <br /> Identify Spill Bucket(By Tank 1 jet fuel 1 2 JET FUEL 2 3 JET 3 4 <br /> .Number,Stored Product, etc. <br /> ®Direct Bury ❑Direct Bury <br /> Bucket Installation Type: ® Direct Bury ®Direct Bury ❑Contained in El Contained in <br /> ❑Contained in Sump ❑Contained in Sump Sump Sum <br /> Bucket Diameter: 11 11 l 1 <br /> Bucket Depth: 13 13 12 <br /> Wait time between applying _ -- <br /> vacuum/water and start of test: <br /> Test Start Time(Ti): 1 1 1 <br /> Initial Reading(Ri): 12 12.75 11 <br /> Test End Time(Tr): 2 2 2 <br /> Final Reading(RF): 12 12.75 11 <br /> Test Duration(TF—TI): IHR IHR 1HR <br /> Change in Reading(RF-RI): 0 0 0 <br /> Pass/Fail Threshold or 1/16 1/16 1/I6 <br /> Criteria: <br /> Test Result: ® Pass ❑Fail ® Pass ❑ Fail ® Pass ❑Fail ❑ Pass ❑ Fail <br /> Comments— (include information on repairs made prior to testing, and recommended follow-tepfor failed lesls) <br /> CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS I ESTING <br /> 1 hereby certify that all the information contained in this report is true,accurate,and in fall compliance with legal requirements. <br /> Technician's Signature: Date 2-22-16 <br /> ' State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements <br /> may be more stringent. <br />