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From:Wendell Gayer Fax:(714)576-2499 To:2094683433@rerex.con Fax: +12094883433 <br /> iRECEIVED <br /> SWRCB,January 2006 <br /> Spill Bucket Testing Report Form SEP 2 8 2016 <br /> This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and <br /> printouts from tests(f applicable),should be provided to the facility owner/operatorfor subE R NTYW METH <br /> 1. FACILITY INFORMATION Facilit ID: PGORPARTMENT <br /> Facility Name: Pacific Gas and Electric Company_ I Date of Testing: 9-12-2016 <br /> Facility Address: 4040 West Ln. Stockton CA 95204 <br /> Facility Contact: Alex Steele I Phone: 209-337-8902 <br /> Date Local Agency Was Notified of Testing: 8-22-2016 <br /> Name of Local Agency Inspector(f present during testing): Victoria McCartney <br /> 2. TESTING CONTRACTOR INFORN4ATION <br /> Company Name: TAIT Environmental Services <br /> Technician Conducting Test: Garrett Warren <br /> Credentials': ❑x CSLB Contractor ®ICC Service Tech. ❑SWRCB Tank Tester ❑Other(Sped) <br /> License Number(s): A B ASB C-10 HAZ,588098 <br /> 3. SPILL BUCKET TESTING INFORMATION _ <br /> Test Method Used: x❑Hydrostatic []Vacuum []Other <br /> Test Equipment Used: Incon TS-STS Equipment Resolution: .0006 <br /> Identify Spill Bucket(By Tank 1 2 3 4 <br /> Number,Stored Product, etc.) Unleaded Diesel Waste Oil <br /> x❑Direct Bury ®Direct Bury EDirect Bury QDirect Bury <br /> Bucket Installation Type: []Contained in Sump ❑Contained in Sump ❑Contained in Sump ❑Contained in Sump <br /> []On Top of AST ❑On Top of AST []On Top of AST []On Top of AST <br /> Bucket Diameter: 11" 11" 11" <br /> Bucket Depth: 14" 14" 13.50" <br /> Wait time between applying <br /> vacuum/water and start of test: 15 min 15 min 15 min <br /> Test Start Time(TO: 12:24pm/12:40pm 12:24pm/12:40pm 2:33pm/2:48pm <br /> Initial Reading(RO: 5.4080/5.4075 5.4027/5.4030 7.5739/7.5744 <br /> Test End Time(TF): 12:40pm/12:55pm 12:40pm/12:55pm 2:48pm/3:03pm <br /> Final Reading(RF): 5.4076/5.4075 5.4031 /5.4038 7.5743/7.5744 <br /> Test Duration(TF—TI): 15 min/15 min 15 min/15 min 15 min/15 min <br /> Change in Reading(RF-RD: .0004/0 .0004/.0008 .0004/0 <br /> Pass/Fa'I Threshold or .002 .002 .002 <br /> Criteria: _ <br /> Test Result: ® Pass []FailZPass ❑Fail x❑Pass ❑Fail E] Pass []Fail <br /> Colnnlellts— (include information on repairs made prior to testing, and recommended follow-up for•fuilecl tests) <br /> Test water was left on site. <br /> CERTIFICATION OF TECffivICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> I herebv certify that all the information contained in this report is true,accurate,and in full compliance with legal requirements. <br /> Technician's Signature: th�'t/avxIr Date: 9-12-2016 <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 />