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9255517888 Llne 1 15:19:39 12-04-2015 1 /1 <br /> 6ETTLER - RYAN INC. _1 VEL.M .-C"L . . . <br /> DEC 04 2015 <br /> TESTING NOTIFICATION Job# 20-640046r <br /> X7ptTN r11=t7A0TAAi=1ks1. <br /> Notification Date 121412015 <br /> Requested Test Date 1/7/2016 Requested Time: gam <br /> Facility Name Arco 2186 Repairs Requested El <br /> Facility Address 3212 N California Startup Test ❑ <br /> Cit /State Stockton,CA Annual Test OX <br /> Agency Notified San Joaquin County EHD Method: <br /> Contact Person Verbal <br /> Telephone: 209-468-8257 Fax Qx <br /> Fax: 209-468-3433 E-Mail El <br /> Testing Scope(check all that apply) <br /> Tank Monitor Certification: 0 VR201-202 Exhibit 5 <br /> Spill Bucket: 0 VR201-202 Exhibit 7 ❑ <br /> Secondary Containment(SB989): F VR201-202 Exhibit 8 <br /> 3GPH Simulation: ❑R VR201-202 Exhibit 9 <br /> TP201.1 B VR203-204 Exhibit 5 <br /> TP201.1C/D VR203-204 Exhibit 6 <br /> TP201.1 E F-] VR203-204 Exhibit 8 <br /> TP201.3 VR203-204 Exhibit 9 F7 <br /> TP201.3B VR203-204 Exhibit 10 L1 <br /> TP201.4 ❑ VR203-204 Exhibit 11 71 <br /> TP201.6 F-1 VR203-204 Exhibit 12 <br /> Healy Dispenser Integrity VR203-204 Exhibit 13 <br /> VR201-202 Exhibit F� VR203-204 Exhibit 14 <br /> Repair scope: Annual Monitor Certification <br /> Technician Assigned to:Chris San Nicolas 925-570-4088 <br /> Notification Contact: Wendy Beach Contact Phone#: 925-551-7555 <br /> GBRER-RY4N INC. Once - 925-551-7.555 Par - 925-5514770 email - urm(iinl@grine.com �� <br />