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9255597888 Line 1FfEEIVET <br />91-18-2013 7117 <br />rwm VA CIETTLER-RYAN INc. 0 <br />3 <br />SWRCB, January 2006 <br />Spill Bucket Testing Report Form N Q V 18 2013 <br />This form is intended for use by contractors performing annual testing of UST spill containment structttrW. The Completed fora and <br />Printouts from tests Cf applicable), should be provided to the facility owner/operator for ry agency. <br />1 VArTT YTV YWWd,%"1L A"'T sW HFAI T14 Pl1=13n0`rW Yr - <br />Facility Name: Arco 2093 Date of Testing: 11114/2013 <br />Facility Address: 3425 Tracy Blvd., Tracy, CA <br />Facility Contact: Phone: <br />Date Local Agency Was Notified of Testing: <br />ame of Localgency inspector i j�vsena uring test—ino Thuy Tran <br />2. TF.STYNGZ VONT1RACTM2 YNIMUMATTnV <br />Company Name: Gettler-Ryan Inc., 6747 Sierra Court SuiteJ, Dublin, Ca. 94568 pPh.# 925-551»7555 <br />Technician Conducting Test: Chris San Nicolas <br />Credentials: (1) CSLB Contractor ICC service Tech. SWRCB Tank Tester <br />Other (Spec) <br />License Number: 220793 ICC Tech Number: 5296364 -UT <br />1-..RP1T.i.liiTCElTTTVCmTWrTMUdNnhRAIr WT <br />Test Method Used: <br />Hvdrastatic <br />_' Vacuum_e <br />Other <br />Test Equipment Used. <br />Standard Tape Measurer <br />Equipment Resolution: <br />1116" <br />Identify Spill Bucket (By Tank <br />Number, Stored Product, etc. <br />1 87 Vapor <br />2 87 Vapor <br />3 87 Vapor <br />4 91 Vapor <br />Bucket Installation Type: <br />Bucket Diameter: <br />Direct Bury <br />X Contained in Sump <br />12" <br />Direct Bury <br />X Contained in Sump <br />12" <br />Direct Bury <br />X Contained in Sump <br />1201 <br />Direct Bury <br />X Contained in Sump <br />1211 <br />Bucket Depth: <br />111, <br />1111 <br />1101 <br />1311 <br />Wait time between applying <br />vacuum/water and start of test: <br />10mm <br />lOmOn <br />lOmin <br />10min <br />Test Start Time (Ti): <br />2:00 <br />2:00 <br />2:00 <br />2:00 <br />Initial Reading (Ri): <br />10'1 <br />1011 <br />1011 <br />1211 <br />Test End Time (Tf): <br />3:00 <br />3:00 <br />3:00 <br />3:00 <br />Final Reading (Rf) <br />10" <br />10" <br />1011 <br />1211 <br />Test duration (Tf - Ti): <br />1hr <br />lhr <br />lhr <br />1hr <br />Change in Reading (Rf-Ri): <br />0 <br />0 <br />0 <br />0 <br />Pass/Fail Threshold or Criteria: <br />0 <br />0 <br />0 <br />0 <br />Test Results: <br />X Pass Fail I <br />X Pass Fair : <br />X Pass Fait <br />X Pass Fail <br />Comments- (include information on repairs made prior to testing, and recommendedfollow-up for failed tests) <br />CERTFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br />I hereby certify that all the information contained in this report is true, accurate, and in full compliance with legal requirements <br />Technician's Signature: <br />Date: 11/14/2013 <br />(1) State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements <br />may be more stringent. <br />