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Sjol Bucket Testing Report Fon* <br />This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and printouts <br />from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. <br />1. FACILITY INFORMATION CLLC: TRACCA11 GEO PAR: UE -058 <br />Facility Name: AT&T/SBC Date of Testing: 7/19/06 <br />Facility Address: 10 E. 12TH STREET, TRACY <br />Facility Contact: TOM WILLIAMS Phone: 209-466-1010 <br />Date Local Agency Was Notified of Testing : 48 HOURS PRIOR (MIN) <br />Name of Local Agency Inspector (if present during testing): SAN JOAQUIN ENVIRONMENTAL HEALTH <br />Company Name: TAIT ENVIRONMENTAL SYSTEMS <br />Technician Conducting Test: MICHAEL L. STRAWN, II <br />Credentials: ® CSLB Contractor ® ICC Service Tech. SWRCB Tank Tester Other (Specify) <br />License Number(s): A B ASB C-10 HAZ License Number: 588098 <br />3. SPILL BUCKET TESTING INFORMATION <br />Test Method Used_ M Hvdrostatic Vacuum Other <br />Test Equipment Used: VISUAL / MEASURE <br />Equipment Resolution: <br />Identify Spill Bucket (By Tank 1 TANK #1232 <br />Number, Stored Product, DIESEL FILL <br />etc.) BUCKET <br />Bucket Installation Type: Direct Bury <br />® Contained in Sump <br />2 <br />Direct Bury <br />Contained in Sump <br />3 <br />Direct Bury <br />Contained in Sump <br />4 <br />Direct Bury <br />Contained in Sum <br />Bucket Diameter: 11" <br />Bucket Depth: 10" <br />Wait time between applying 15 MINUTES <br />vacuum/water and start of test: <br />Test Start Time (Tj): 12:30 P.M. <br />Initial Reading (Rj): 7" <br />Test End Time (TF): 1:00 P.M. <br />Final Reading (RF): 3" <br />Test Duration (TF — Tj): V2 HOUR <br />Change in Reading (RF - Rj): 3" <br />Pass/Fail Threshold or .002" <br />Criteria: <br />Test Result: Pass Z Fail <br />Pass Fail <br />Pass Fail <br />Pass Fail <br />Con <br />merits — (include information on repairs made prior to testing, and recommended follow-up for failed tests) <br />*All hazardous test water was re -contained in (1) 5 gallon steel drum. Drum is labeled non-haz and is <br />Ready for pick-up. <br />*Diesel fill bucket failed. Replacement or repair is needed. <br />CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br />I hereby certify that all the information contained in this report is true, accurate, and in fidl compliance with legal requirements. <br />Technician's <br />Date: -7/19/06 <br />