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f k ' <br />Ir -1 <br />A lite ch <br />Compliance without Compromise <br />Vapor Spill Bucket Testinq Report Form <br />FACILITY INFORMATION: <br />0 <br />Sonoma CA 95370 <br />Ca: 623541 A-Haz <br />Phdde:209-532-7320 <br />Fax: 209-533-2650 <br />mail@alltechpetro.com <br />www.alltechpetro.com <br />Facility Name: Costco # 1031 Manteca I Date of Testing: August 18, 2016 <br />Facility Address. 2440 Daniel St. Manteca, Ca <br />Facility Contact: Dave Zizzo Phone: <br />Name of Local Agency Inspector: Stacy Rivera <br />SPILL BUCKET TESTING INFORMATION: <br />Test Method Used: N Hydrostatic <br />❑ Vacuum <br />❑ Other <br />Test Equipment Used: 1 -Hour Observed Test <br />Equipment Resolution: 1/16" <br />Identify Spill Bucket <br />1 87A Vapor <br />2 87B Vapor <br />3 91 Vapor <br />4 Additive Aux <br />Bucket Installation Type: <br />❑ Direct Bury <br />❑ Direct Bury <br />❑ Direct Bury <br />❑ Direct Bury <br />In Sump <br />® In Sum <br />® In Sum <br />N In Sum <br />Wait time between <br />applying vacuum/water <br />None <br />None <br />None <br />None <br />and start of test: <br />Test Start Time (T,): 8:00 am <br />8:00 am <br />8:00 am <br />8:00 am <br />Initial Reading (R,): Top of cap <br />Top of cap <br />Top of cap <br />Top of cap <br />Top f c <br />Test End Time (TF): <br />9:00 am <br />9:00 am <br />9:0Oa <br />�9'00 <br />Final Reading (RF): Top of cap <br />Top of cap <br />Top of cap <br />Top of cap <br />Test Duration (TF—T,): 1 Hour <br />1 Hour <br />1 Hour <br />1 Hour <br />Change in Reading (RF -R,): None <br />None <br />None <br />None <br />Pass/Fail Threshold or <br />1/16„ <br />Criteria: <br />Test Result: Pass ❑ Fail <br />® Pass Q Fail <br />N Pass ❑ Fail <br />® Pass ❑ Fail <br />Comments -- (include information on repairs made prior to testing, and recommended follow-up for failed <br />tests) <br />CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br />1 hereby certify that all the information contained in this report is true, accurate, and in full compliance with <br />legal requirements. <br />Technician's Signature: <br />Date: 08/18/16 <br />