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SWWII,Jonuaty 2002 <br /> Page I of 7 <br /> Secondary Containment Testing Report Forth <br /> Stockton Service Station Equipment Co., Inc. <br /> 808 N. Union Street, Stockton, CA 95205-4152 (209) 464-8333 FAX(209) 464-8349 <br /> California Contractor License 309105 A-C61/n40 HA7./T41C i-mail leen( acbcll.nel <br /> F <br /> 1. FACILITY INFORMATION <br /> Facility Name; Cas 4 Less nate o1'Testin : 1Febrnar 23,2010 <br /> I�acili Address;3434 Manithe Road,Stockton,CA 95206 <br /> Facili Contact: Gilbert Silva phone: 209.992.7620 <br /> Date Local A ency Was Notified of Tessin <br /> Name orLocal n enc infector(if present during tcsting- <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Com any Name: Stockton Service Station)F ui ment Co.,inc. <br /> Technician ConductingTest: Randy Chadwick <br /> Credentials; [X )CSLB Licensed Contractor SWRCB Licensed'rank Tester <br /> License Type: -C-61/b40 HAZ/IIiC License Number: 309105 <br /> Manufacturer Training <br /> Manufacturer -Component(s) Date Training Expires <br /> 3. SUMMARY OF TEST RESULTS <br /> Component Pnsa Fni! Not Repairs Component PassFall Not Repairs <br /> 7'etcd Madc Tested Madc <br /> fnnlc Annular !mac 2 X X -- <br /> Secondary Pipih ,Pa e 3 X Linder Dispenser Containment Pg.5 x x - <br /> If hydrosWic testing was performed,describe what was done with the water after completion of tests: <br /> PAGES 4, 6, 7 N/A <br /> CERTIFICATION OF TECIiMCIAN I MSPONSIBI.r FOR CONDUCTING T"TS TIC,STING <br /> To the best of my knowledge,the facts stated in this document are accurate and in full compliance with legal requirements. <br /> Technician's Signature: Rc nd Chadwick Date: February 23, 2010 <br />