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SWRCB, January 2006 Spill Bucket Testing Report Form This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and printouts from tests (f applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: SAN JOAQUIN REGIONAL TRANSIT - R T D I Date of Testing: 9/4/2018 Facility Address: 2849 E. MYRTLE AVENUE STOCKTON, CA 95201 Facility Contact: JOHN Phone: Date Local Agency Was Notified of Testing: 8/21/2018 Name of Local Agency Inspector (f present during testing): STACY R. 2. TESTING CONTRACTOR INFORMATION Company Name: AFFORDA TEST 416 2"d Street Galt, CA 95632 (209) 744-0112 Fax: (209) 744-0116 Technician Conducting Test: ❑ Ed Stearns ® Zane A. Nimmo ❑ David A. Winkler ❑ Felix G. Ramirez 8883080 -UT 8883064 -UT 8883059 -UT 8883072 -UT Credentialsl: ®ICC Service Tech. ®SWRCB Tank Tester 3. SPILL BUCKET TESTING INFORMATION Test Method Used: ®Hydrostatic 11 Vacuum U Other Test Equipment Used: TAPE MEASURE, H2O Equipment Resolution: 1/16" Identify Spill Bucket (By Tank 1 87 12 3 DIESEL DT - 1 14 DIESEL DT 2 Number, Stored Product, etc. ❑ Direct Bury E] Direct Bury ❑ Direct Bury ❑ Direct Bury Bucket Installation Type: ® Contained in Sump ❑ Contained in Sump ® Contained in ® Contained in Sump Sum Bucket Diameter: 11 11 11 Bucket Depth: 16 16 16 Wait time between applying vacuum/water and start of test: Test Start Time (TI): 1230 1230 1230 Initial Reading (RI): 16 16 15 1/4 Test End Time (TF): 1330 1330 1330 Final Reading (RF): 16 16 15 1/4 Test Duration (TF — Ti): H O U R Change in Reading (RF - Ri): 0 0 0 Pass/Fail Threshold or ('ritPria• �- _- -- -- Test Result: El Pass ®Fail ❑Pass ❑Fail ®Pass El Fail Comments — (include information on repairs made prior to testing, and recommended follotiv-zrp for failed tests) INSPECTOR CLAIMS TO HAVE SEEN VISIBLE LEAK DURING TEST, HOWEVER FLUID LEVEL DID ®Pass ❑Fail NOT DROP AND A PASSING NUMBER WAS RECORDED, HOWEVER THIS VISIBLE LEAK CONTINUED THROUGHOUT THE ENTIRETY OF THE TEST. I DO NOT AGREE TO THE FAILURE BUT SITE REPRESENATIVE WILL RESCHEDULE A RETEST AND PERFORM IT HIMSELF TO VERIFY MY CONCLUSION CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THI S TESTING I hereby certify that all the information contained in this report is true, accurate, and in full compliance with legal requirements. Technician's Signature: 4f5 Date: 9/4/2018 1 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent.