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Page I <br />Secondary Containment & Overfill Containment Testing <br />Report Form <br />1. FACILITY INFORMATION <br />Facility Name: Ryder Truck Rental I Date: 1/31/2014 <br />Facility Address: 3633 Duck Creek Rd., Stockton, CA 95215 <br />Facility Contact: dames Shannon 71 Phone: (209) 943-3213 <br />Date Local Agency Was Notified of Testing: 12111/2013 <br />Name of Local Agency Inspector (if present during testing): Stacy Rivera <br />2. TESTING CONTRACTOR INFORMATION <br />Company Name: Balch Petroleum Contractors & Builders, Inc. <br />--s <br />Technician Conducting Test: Robert Henninger <br />Credentials: X CSLB Licensed Contractor a SWRCB Licensed Tank Tester <br />License Type: A / B / C-10 / HAZ <br />License Number. 396575 <br />Manufacturer Trainine i <br />Manufacturer Component(s) Date Training Expires <br />Caldwell Hydrostatic Precision Test Equipment NA <br />❑ <br />M <br />3. SUMMARY OF TEST RESULTS <br />Component Pass Fail Not <br />Tested <br />Repairs <br />Made <br />Component Pass Fail Not <br />Tested <br />Repairs <br />Made <br />Waste Oil Fill Sump X -7 <br />-' <br />❑ ❑ ❑ <br />❑ <br />Reserve Diesel Tank Fill Sump X ❑ 0 <br />❑ <br />❑ ❑ <br />❑ J <br />❑ <br />❑ <br />— <br />- ❑ T1 <br />-, <br />❑ ❑ <br />E ❑ ❑ <br />❑ E. <br />0 ❑ <br />2 <br />❑ ❑ <br />f ❑ .i <br />❑ i <br />❑ 9 <br />10 <br />Notes: <br />CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br />To the best of my knowled a act islojed in this document are accurate and in full compliance with legal requirements <br />Technician's Signature: Date: 1/31/2014 <br />