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� D <br /> MAY 2 5 2007 <br /> S WRCR,January 2002 ENVIRONMENT HEALTH <br /> PERMIT/SERVICES Page 1 of 7 <br /> Secondary Containment Testing Report Form <br /> Stockton Service Station Equipment Co., Inc. <br /> 808 N. Union Street,Stockton,CA 95205-4152 (209) 464-8333 FAX(209)464-8349 <br /> California Contractor License 309105.4-C61;D40 HAZJHIC F-rnailssseco(rroacbcll.net <br /> 1. FACILITY INFORMATION <br /> F F`cility Name: ESTES TRANSPORT I Date of Testing: 05.07.2007 <br /> Facility Address: 7611 S.AIRPORT WAY,STOCKTON,CA 95206 <br /> Facility Contacr. Jim Bunck I Phone: 714-893-6140 <br /> 1 Date Local Agency Was Notified of Testing: 05.02.2007 <br /> Name of Local Agency Inspector(if present during testing) <br /> _ 2. TESTING CONTRACTOR INFORMATION <br /> Company Name: Stockton Service Station Equipment Co.,Inc. <br /> Technician Conducting Test: Randy Chadwick _ <br /> _Credentials: IX I CSLB Licensed Contractor _ i 1 SWRCB Licensed Tani:Tester <br /> License Type: C-61/D40 HAVHIC License Number: 309105 <br /> Manufacturer Training <br /> Manufacturer Component(s) Date Training Expires <br /> Bmith Fiberglass Products Company N/A <br /> 3. SUMMARY OF TEST RESULTS <br /> Ccnnponent Pass Fail NotRepairs - Component Pass Fail Not Repairs <br /> 'Fcs[ed Made Tested Made <br /> SeconJa rc Yi eTestin ,Fa c} X __ _ � <br /> I PI—ilink SumtTestin ,Page4 x <br /> Under-Dispenser Contain.Pa,e 5_ J XJ <br /> If hydrostatic testing was performed,describe what was done with the water after completion of tests: <br /> Approximately 200 gallons contaminated water put into drums for Certified Waste Hauler to pick <br /> up, <br /> Pages 2, 6, 7 N/A <br /> CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING'I'InSTESTINC <br /> To the best of my knowledge,the facts stated in this document are accurate and in full compliance with legal requirements. <br /> Technician's Signature: Randy Chadivick Date: Mav 7, 2007 <br />