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HEGEI V EL <br />MAR 2 3 2015 <br />[�NVIFtONMENTA? <br />1. RAfTIJTV IMMUMA'rl"N i•.rw.. ncr)1^T""'-"'"'` <br />Facility Name: Safeway 0 2707 1 Date of Testing: 2/27/75 <br />Facility Address: 6425 N. Pacific Avenue—Stockton CA 95207 <br />Facility Contact j Phone: (209) 472-8600 <br />Date Local Agcncy Was Notified orresting: : SB989— Repair & Re -Test Results <br />Name of Local Agency Inspector (ifpresenr during testing/: Fatinah Zarcef <br />2_ TF.CTINC rnNTnArTnV TWWnD TrnN <br />Company Name: ABLE Maintenance, Inc. <br />Technician Conducting Test: Nick Andrews/ I.C.C. H8180923 <br />Credentials: ® CSLB Licensed Contractor SWRCI3 Lisansed Tank Tester <br />License Type: A, B, I1az., CIO License==.Jumbcc 312844 <br />Manufacturer Trainine <br />Manufacturer .. Component(s) Datc Training Expires <br />Available upon request <br />If hydrostatic testing was performed, describe what was done with the water after completion of tests: <br />Used autnn test <br />