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n AUG 2 8 Mh, January 2006 Spill Bucket Testing Report For I_ This form is intended for use by contractors performing annual testing of UST spill containmehttwattrta rer luted form and printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facilitv ID: UE042 Facility Name: Pacific Bell Telephone Co dba ATT California Date of Testing: 2015/08/20 Facility Address: 345 N. San Joaquin Stockton CA 95202 Facility Contact: Thuy Tran I Phone: (209) 532-3447 Date Local Agency Was Notified of Testing: 2015/08/13 Name of Local Agency Inspector (if present during testing): Cindy Vo 2. TESTING CONTRACTOR INFORMATION Company Name: TAIT Environmental Services Technician Conducting Test: Dan Luck Credentials': ECSLB Contractor FICC Service Tech. ❑SWRCB Tank Tester [I Other (Specify) License Number(s): A B ASB C-10 HAZ., 588098 ICC Service Tech #5252167 3. SPILL BUCKET TESTING INFORMATION Test Method Used: EHydrostatic []Vacuum []Other Test Equipment Used: Tape Measure Equipment Resolution: 1/16" Identify Spill Bucket (By Tank Number, Stored Product, etc. 1 UE0420001 2 3 4 Bucket Installation Type: ❑Direct Bury EContained in Sump ❑On Top of AST ❑Direct Bury ❑Direct Bury ❑Contained in Sump ❑Contained in Sump ❑On Top of AST []On Top of AST []Direct Bury ❑Contained in Sump ❑On Top of AST Bucket Diameter: 11" Bucket Depth: 14 1/4" Wait time between applying vacuum/water and start of test: 15 min Test Start Time (Tj): 9:26 am Initial Reading (Rj): 12 1/2" Test End Time (TF): 10:26 am Final Reading (RF): 12 1/2" Test Duration (TF — Ti): 1 hour Change in Reading (RF - RI): 0 Pass/Fail Threshold or Criteria: 0 Test Result: E Pass ❑Fail ❑ Pass ❑Fail ❑Pass ❑Fail ❑ Pass ` ❑Fail Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) Test water returned to Tait shop. CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report is true, accurate, and in full compliance with legal requirements. Technician's Signature: V" ZW41 Date: 2015/08/20 ' State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent.