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' SWRCB, January 2006 <br /> � <br /> Spill Bucket Testlri <br /> This form is intended for use by contractors performing annual testing of Report <br /> containment structures. <br /> t Form <br /> printouts from tests(f applicable)should be provided to the facility owner/operator fThe completed form and <br /> or submittal to the local <br /> 4. FACILITY regulatory agency. <br /> Facility Name: �'F©'RMATION <br /> TIME OIL#07-049 <br /> Facility Address: 14000 E. HWY 88, LOCKEFORD, CA 88237 Date of Testing: APR 3,2007 <br /> Facility Contact: CHUCK SOFTICH <br /> Date Local Agency Was Notified of Testing: Phone: 800-426-0235 <br /> Name of Local Agency inspector i MAR 20, 2007 <br /> P (f present during testing: WILLIE NG <br /> 5. TESTING CONTRACTOR INFORMATION <br /> Company Name: TANK-iTEK ENVIRONMENTAL CORPORATION <br /> Technician Conducting Test: ROB NEIMEYER <br /> Credentials: O CSL$ Contractor <br /> ❑ ICC Service Tech, ❑ SWRCB Tank Tester <br /> License Number(s): 803705 0 Other(Spec) <br /> Test Method Used: 6. SPILL BUCKET TESTING INFORMATION <br /> Hydrostatic © Vacuum <br /> Test Equipment I]sed: 11 Other(Specify) <br /> I Equipment Resolution: <br /> Identify Spill Bucket(By Tank <br /> Number, Stored Product, etc.) DIESEL <br /> Bucket Installation Type: Z Direct Bury <br /> ❑Direct Bury Direct Bu <br /> ❑ Contained in Sump ❑Contained in Sum ry Q Direct Bury <br /> Bucket Diameter: p Q Contained in Sump ❑ Contained in Sump <br /> 10.50" <br /> Bucket Depth: 12.001, <br /> Wait time between applying <br /> vacuum/water and start of test: 0 <br /> Test Start Time(TI): 9:00 AM <br /> Initial Reading(Rt): 12.00" <br /> Test End Time(TF): 9:30 AM <br /> Final Reading(RF): 12.00" <br /> Test Duration(TF-Tt): 30 MIN <br /> Change in Reading(RF-R2): 0 <br /> Pass/Fail Threshold or Criteria: <br /> Test Result: 11 ® Pass ❑ Fail <br /> ❑ Pass [I Fail ❑ pass ❑Fail ❑ Pass <br /> COMM eats-(include information on repairs made prior to testing, and recommended ollow-u d Fail <br /> g f p for failed tests} <br /> CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> I hereby eertify that all the information contained in this report is true,accurate, and in full compliance with legal requirements. <br /> Technician's Signature: 69-'IL// _ <br /> �- Date. APR 3,2007 <br /> t State laws and regulations do not cLTrently require testing to be performed by a qualified contractor. However, local requirements <br /> may be more stringent. <br />