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AUG-29-2011 15:19 Service Station Systems 408 938 8888 P.03iO4 <br /> 1. FACILITY INFORMATION <br /> Facility Namc: SHELL/USA#68153 Date of Testing: 7/29/11 - <br /> Facility Address; 2448 W.Kettleman Lane—Lodi CA 95242 <br /> Facility Contact: Phone: <br /> Date Local Agency Was Notified of'resting:7/27/11 SB989— <br /> Name of Local Agency Inspector(if present during testing}: Michelle Henry <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company Name:ABLE Maintenance,Inc. _ <br /> Technician Conducting Test; Sammy Sousa ICC#5254516-1UT <br /> Credentials: ® CSLB Licensed Contractor SWRCB Licensed Tank Tester <br /> License Type:A,B,Haz.,CIO License Number: 312844 <br /> Manufacturer Training <br /> Ma.nui'aeturer Com onent s Date Tmining Expires <br /> Available upon request <br /> 3. SUMMARY OF TEST RESULTS <br /> Component: Pass Fail Not Repairs Component: Pass Fail Not Repairs <br /> Tested Made Tested Made <br /> Diesel Turbine Sump ® ❑ ❑ IM ❑ ❑ ❑ ❑ <br /> 0 ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ o ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ 1 ❑ ❑ 1 ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ o <br /> ❑ ❑ ❑ ❑ ❑ ❑ 1 ❑ <br /> ❑ ❑ ❑ ❑ <br /> If hydrostatic testing was performed,describe what was done with the water after completion of tests: <br /> Left 2 x 55 gallon drums on site <br />