Laserfiche WebLink
Spill Bucket Testing Report Form <br />1_ FACILITY INFORMATInN <br />Facility Name: FAST AND EASY Date of Testing: 4/21/2014/ <br />Facility Address: 10878 N. HWY 99 STOCTON CA, <br />Facility Contact: MIKE ALE Phone: <br />Date Local Agency was notified of Testing: 4/02/2013 <br />Name of Local Agency Inspector (if present during testing:) GARET BUKES <br />2.TESTING CONTRACTOR INFROMATION <br />Company Name: Mid Valley Consulting & General Engineering <br />Technician Conducting Test: JASON HAASE <br />Credentials: CSLB Contractor ICC Service Tech. SWRCB Tank tester <br />License Number(s): 920985 8165409 -UC <br />1. SPILL BUCKET TESTING INFORMATION <br />Test Method Use: x Hydrostatic Vacuum Other <br />Test Equipment Used: Pump Equipment Resolution: <br />Comments: - (include infromation on repairs made prior to testing, and recommended foilow-up for failed tests) <br />THE SPILL CONTANMENT ON THE PREMIUM IS CRACKED AT THE BOTTOM IT DID NOT PASS. THE <br />BUCKET NEEDS TO BE REPLACED AND RETESED. <br />I hereby certify that 11 th informat'on i this report is true, and in full compliance with legal requirements. <br />Technician's Signatu e: Date: 04/21/2014 <br />Identify Spill Bucket (By Tank <br />Number, Stored Product) <br />1.PREMWM <br />2. PLUS <br />3. UNLEADED <br />4. DIESEL <br />Bucket Installtion Type: <br />X Direct Bury <br />Contained in Sump <br />X Direct Bury <br />Contained in Sump <br />X Direct Bury <br />Contained in Sump <br />X Direct Bury <br />Contained in Sump <br />Bucket Diameter: <br />12" <br />12" <br />12" <br />12" <br />Bucket Depth: <br />12" <br />12.75" <br />12.50" <br />16" <br />Wait time between applying <br />vacuum/water and start of test: <br />5 MIN <br />5 MIN <br />5 MIN <br />5 MIN <br />Test Start Time (TI): <br />9:00 AM <br />9:00 AM <br />9:00 AM <br />9:00 AM <br />Initial Reading (Rl): <br />11" <br />11.75" <br />11.50" <br />15" <br />Test End Time (Tf): <br />9;10 AM <br />10:00 AM <br />10:00 AM <br />10:00 AM <br />Final Reading (Rf): <br />6" <br />11.75" <br />11.50" <br />15" <br />Test Duration (Tf-Tl): <br />10 MIN <br />1 HR <br />1 HR <br />I HR <br />Change in Reading (Rf-Rl): <br />5" <br />0 <br />0 <br />0 <br />Pass/Fail Threshold or Criteria: <br />.025" <br />.025" <br />.025" <br />.025" <br />Test Results: <br />Pass X Fail <br />X Pass Fail I <br />X Pass Fail X Pass Fail <br />Comments: - (include infromation on repairs made prior to testing, and recommended foilow-up for failed tests) <br />THE SPILL CONTANMENT ON THE PREMIUM IS CRACKED AT THE BOTTOM IT DID NOT PASS. THE <br />BUCKET NEEDS TO BE REPLACED AND RETESED. <br />I hereby certify that 11 th informat'on i this report is true, and in full compliance with legal requirements. <br />Technician's Signatu e: Date: 04/21/2014 <br />