Laserfiche WebLink
Page 1. <br /> �y 2002 <br /> orm <br /> Seconda Containment Testing Repo <br /> rrn is intended for use by contractors t ors p or allgperiodic testin is tested. The completeUST df <br /> containment <br /> test procedures,and <br /> riate pages of this form to rep f <br /> applicable), should be provided to t <br /> touts from tests(if 'heT i INFORMATIONoatorf submittal to the local regulatory agency. <br /> 1. FACILITY <br /> FacilityName: CONOCO PHILLIPS #2708671 <br /> Date of Testing: 10/18/2007 <br /> 09 <br /> Facility Address: 8606 THORNTON ROAD STOCKTON, CA, 952 Phone: (209) 478-8959 <br /> Facility Co-'--" MANAGER <br /> Date Local Agency Was Notified of Testing: <br /> Name of Local Agency Inspector(if present during testing): <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company Name: TANKNOLOGY, INC. <br /> Technician Conducting Test: <br /> GREGORY MCHALE <br /> Credentials: <br /> CSLB Licensed Contractor ❑ SWRCB Licensed Tank Tester <br /> License Number: 74316 <br /> 0 <br /> License Type: A <br /> Manufacturer Training Date Training Expires <br /> Manufacturer Component(s) <br /> 10/03/2009 <br /> TANKNOLOGY ALL <br /> 3. SUMMARY OF TEST RESULTS <br /> Not Repair <br /> Not Repairs Component Pass Fail Tested <br /> Component Pass Fail Tested Made ❑ <br /> ElEl ❑ ❑ ❑ <br /> El Annular 2 P E—Kil ❑ ❑ ❑ ❑ <br /> Tank Annular 1 PRE1:1a ❑ ❑ ❑ ❑ ❑ ❑ <br /> Tank Annular 3 UNL ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> Secondary Pipe 1 PRE ❑X ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> Piping Sump 1 PRE X ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑EJ El EJ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ <br /> If hydrostatic testing was performed,describe what was done with the water after completion of tests: <br /> TAKEN <br /> CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements <br /> Date: 10/18/2007 <br /> Technician's Signature: P 4,r+i v <br />