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Alltech Petro Inc. <br />17759 Buttercup Circle, Sonora, CA 95370 <br />Phone: 209-532-7320; Fax: 209-533-2650 <br />California Contractor 623541 A-Haz <br />ICC Technician: 8005930 -UT <br />SWRCB Tank Tester: 09-1749 <br />alltechmailOunte.com <br />Spill Bucket Testing Report Form <br />FACILITY INFORMATION: <br />Facility Name: Costco # 1031 Manteca I Date of Testing: Tuesday, August 18, 2009 <br />Facility Address: 2440 Daniel St. Manteca, Ca <br />Facility Contact: Julian Ochoa Phone: <br />Name of Local Agency Inspector: Michelle Henry <br />SPILL BUCKET TESTING INFORMATION: <br />Lest Method Used: Z Hydrostatic ❑ Vacuum 7 0[her <br />Test Equipment Used: I -Flour Observed Test 1=1111, ment Resolution: 1/16" <br />Identity Spill Bucket <br />I Reg 87A <br />2 Re„ 87 B 3 Premium <br />4 <br />Bucket Installation Type: <br />Ll Direct Bur} <br />(H In Sump <br />Direct Bury Direct 11ur<<Lj <br />® In Sump ❑ In SLU11P <br />Direct Bury <br />❑ In Sum <br />Wait time between applying <br />vacuum/water and start of test: <br />None <br />None None <br />Test Start Time (Tj): <br />8:30 <br />8:30 8:45 <br />Initial Reading (R[): <br />2.00" above cap <br />2.25" above cap 2.50" above cap <br />Test End Time (TF): <br />10:00 <br />10:00 10:00 <br />Final Reading (RF): <br />2.00" above cap <br />2.2.5" above cap 2.50" above cap <br />Test Duration (TF — Tt): <br />1.5 Hours <br />1.5 Hours 1.25 Hours <br />Change in Reading (RF -R,): <br />None <br />None None <br />Pass/Fail Threshold or <br />Criteria: <br />1/t6" <br />1/16" 1/16" <br />Test Result: <br />Pass ❑ Fail <br />® Pass ❑ Fail ® Pass ❑ Fail <br />❑ Pass ❑ Fail <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 certyythat all the information contained in this report is true, accurate, and in full compliance with legal requirements. <br />Technician's Signature: �p <br />Date: 8/18/09 <br />