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0 0 <br />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 />SWRC13 Tank Tester: 09-1749 <br />alltechmailCivrne. com <br />Spill Bucket Testing Report Form <br />FACILITY INFORMATION: <br />SPILL BUCKET TESTING INFORMATION: <br />Test Method Used: ❑ Hydrostatic ❑ Vacuum U Other <br />Test Equipment Used: 1-1 iour Observed Test <br />Equipment Resolution: 1/16" <br />Identify Spill Bucket <br />1 Reg 87A <br />2 Reg 87 B <br />3 Premium <br />4 <br />Bucket Installation Type: <br />Direct Bury <br />® In Sump <br />Direct Bury <br />® in Sump <br />U Direct Bury <br />® In Sump <br />Direct Bury <br />In Sum <br />Wait time between applying <br />vacuum/water and start of test: <br />None <br />None <br />None <br />Test Start Time (Ti): <br />8:30 <br />8:30 <br />8:45 <br />Initial Reading (R[): <br />2.00" above cap <br />2.25" above cap <br />2.50" above cap <br />Test End Time (TF): <br />10:00 <br />10:00 <br />10:00 <br />Final Reading (RF): <br />2.00" above cap <br />2.25" above cap <br />2.50" above cap <br />Test Duration (TF — T,): <br />1.5 Hours <br />1.5 Hours <br />1.25 Hours <br />Change in Reading (RF -Rt): <br />None <br />None <br />None <br />[lass/Fail Threshold or <br />Criteria: <br />1/16" <br />1/16" <br />1/16" <br />Test Result: <br />® Pass ❑ Fail <br />® Pass ❑ Fail <br />® Pass [--]Fail <br />❑ Pass ❑ Fail <br />Comments — (include information on repairs made prior to testing, and recommended allow -u for ailed 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 Si;nature <br />Date: 8/18/09 <br />