Laserfiche WebLink
MAY 2 5 2%-PCB,January 3006 <br /> Spill Bucket Testing Report ForIPNVI20NMENT HEALTH <br /> This form is intended jar use by contractors performing annual testing of USTspill cmaainnreRETI&E. apleted form and <br /> printouts from tests (if applicable), should be provided to the facility owner%operator for submittal to the local regulatory agency. <br /> 1. FACILITY INFORMATION <br /> Facility Name: Estes Trucking Date of Testing: May 04,2007 <br /> Facility Address: 7611 S.Airport Way,Stockton,CA 95206 <br /> li Facility Contact: Jim Bunck Phone: 714-893-6140 <br /> [Date Local Agency Was Notified of Testing: May 2,2007 �. <br /> Name of Local Agency Inspector(if'present during testing): Muni <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company Name: STOCKTON SERVICE STATION EQUIPMENT CO.INC <br /> Technician Conducting Test: Eric Molgaard <br /> Credentials': �j CSLB Contractor (x)ICC Service Tech. SWRCB Tani:Tester 0 Other(Specify) <br /> 1 License Number(s):_ —_ICC 52511200-UT <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: (x) Hydrostatic ❑Vacuum - ❑Other <br /> Test Equipment Used: Tape and Water Finding Paste Equipment Resolution: <br /> Identify Spill Bucket(By Tank 1 DIESEL FUEL 2 3 4 <br /> Number, Stored Product, etc. <br /> (x) Direct Bury ❑Direct Bury ❑Direct Bur 0 Direct Bur <br /> Bucket Installation Type: Y Y <br /> I, 0 Contained in Sump 71,Contained in Sump ❑Contained in Sump ❑Contained in Sum <br /> Bucket Diameter: 24 inch <br /> Bucket Depth: 18 inch <br /> Wait time between applying 3 minutes <br /> vacuum/water and start of test: <br /> Test Start Time(T,): j 1:00 P.M. <br /> Initial Reading(R,): 7-1/4 inch <br /> i <br /> Test End Time(TF): 2:00 p.m. <br /> - �- <br /> I inal Reading(RF): 7-I/4 inch - - — <br /> Test Duration jr.-T,): I hour <br /> Change in Reading(RF-R,): -0- <br /> Pass/Fail Threshold or <br /> Criteria: 7-1/16 inch <br /> Test Result: (x)Pass ❑Fail ❑ Pass ❑Fail ❑ Pass ❑Fail ❑ Pass ❑Faitl <br /> Comments- (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br /> CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> I hereby certify that all the information contained in this report is true,accurate, and in full compliance with legal requirements. <br /> Technician's Signature: Eric NoCgaaref Date: May 4,2007 <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 />