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RMOOMVED <br /> 12/15/2014 9:03PN F�X 18252360871 Ouadalupe Sanchez Goole/0616 <br /> DEC 16 2014 <br /> SWR(-B,Tanuary 2006 <br /> Spill.Bucket Testing RepO>I *"N'pMpE;NIAL HEALTH <br /> 7'sris,form[s intended for use by conrraarorsperforming annual testing of LST spill eoruai> xPTtY trN+ lrtr' e compteredform and <br /> printouts from IOU Of applicable),shauld be rrnvided to thefacility own er/operatorfor submittal to the local regulatory agency. <br /> 1. FACILM INFORMATION <br /> Facility Name: ARCO Date oFTesting: I1/25t2014 <br /> Facility Address: 4855 9,State Route 9,Stockton,Ca,95215 <br /> Facility Contact Gill I Phone: (209)481-7445 <br /> Date Local Agency Was Notified of Testing: Jl-12--/ <br /> Name of Local Agency Inspector(ifpresent during testing): Jeff Wong <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company Name: Reliable Petroleum Services Inc. <br /> Technician Conducting Test Guadalupe Sanchez <br /> Credentials': x CSLB Contractor x 1CC Service Tech, M SWRCB Tank Teslor ❑Other ecify) <br /> LicenseNumber(s): 883706 5250451 <br /> 3. SPILL BUCKET TESTING WORMATION <br /> Test Method Used: aRydrostatic D Vacuum i i Other <br /> 'fest Equipment Used: Standard Tape Measure Equipment Resolution: N/A <br /> Identify Spill Bucket(By Tank I Tl:87 Fill SE 2 TI:87 PW NE 3 T2: 89 Fill 4 T3:91 Fill <br /> Number,Storedproduct, etc. <br /> Bucka instal lation Type: Dirm Bury Direct Bury Dimcc Bury DirectBury <br /> x Contained is Sump x Contained in Sump x Contained in Sump x Contained in Sum <br /> BuuketDiameter. 12" 12" 12" 12" <br /> Bucket Depth: 13 1/1" 13 %" 13 W 131V <br /> Wait lune between applying I minute 1 minute 1 minute I minute <br /> vacuumlwatdr and start oft"; <br /> 'Fest Start'I'iate(Q: 2:40 p.m. 2:40 p.m. 2:40 p.m. 2:40 p.m. <br /> Initial Reading(R,): 11 Mr, 111/8" 11318" 11518" <br /> Test End Time(T;): 3:40 p.m. 3:40 p.m. 3:40 p.m. 3:40 pm. <br /> Fine[Reading(R4 11 IJ8" 111/8" 113/8" 11518" <br /> Test Duration(TF-T,): 1 hr lhr 1 hr I hr <br /> Change in Reading(Re-Rt): 0 0 0 0 <br /> Pasg7Fail Threshold or 1/16" 1/16^ 1116" till?, <br /> Criteria: <br /> Test Result: x Pass f.l Fal x Pass D Fag s Paas ❑Fait x Pass DMI <br /> C0MM0its-rJncbtde information on repairs made prior to res Ap,and recommended fdlow-vp forfafie d tests) <br /> CERTIFICATION OF TECIiNICIAN RESPON SIBLE FOR CONDUCTING THIS TESTING <br /> I hereby certify that ail the urfar��m__ado''n contained in this rep oil is tme,accurate,and in fiull compliance with leg at tegairemell is. <br /> Technician's Signatures� c��c Date 11/25P-014 <br /> 'State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements <br /> may be more stringent. <br /> LL'd £9699b960Z wneloi;edejgege�A e6L:10gL9L0a4 <br />