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AlItech Petro <br /> Inc. <br /> P.O. BOR 4208, Sonora, CA 95370 <br /> Phone: 209-532-7320; Fax: 209-533-2650 <br /> California Contractor 623541 A-Haz <br /> a lltechmailA,rnac.corn <br /> Spill Bucket Testing Report Form <br /> FACILITY INFORMATION: <br /> Facility Name: Hammer I-5 Arco Date of Testing: Thursday,August 26,2010 <br /> Facility Address: 3201 W.Hammer Lane Stockton CA <br /> Facility Contact: Wes Parkinson Phone: (209)474-9125 <br /> Notification Date of Local Agency:8/5/10 <br /> Name of Local Agency Inspector:Garret Backus <br /> SPILL BUCKET TESTING INFORMATION: <br /> Test Method Used: ®Hydrostatic ❑Vacuum Other <br /> Test Equipment Used: 1-Hour Observed Test Equipment Resolution: 1/16" <br /> . ,. ,. . e.,,v r• ,,. ., .., , .•..d: r > <br /> Identify Spill Bucket 187A Master 2 87B Syphon 3 91 4 <br /> Bucket Installation Type: Direct Bury Direct Bury Direct Bury Direct Bury <br /> ®In Sump ®In Sump ®In Sump ❑ In Sum <br /> Wait time between applying None None None <br /> vacuum/water and start of test: <br /> Test Start Time(Ti): <br /> Initial Reading(RI): Gross Fail 2"From top 2 3/8"From top <br /> Test End Time(TF): <br /> Final Reading(RF): Gross Fail 2"From top 2 3/8"From top <br /> Test Duration(TF—TI): 1.0 Hr 1.0 Hr <br /> Change in Reading(RF-RI): 0.0 0.0 0.0 <br /> Pass/Fail Threshold or 1/16" 1/16" 1/16" <br /> Criteria: <br /> Test Result: ❑ Pass ®Fail ® Pass ❑Fail ® Pass ❑Fail ❑ Pass ❑Fail <br /> Comments—(include information on repairs made prior to testing, and recommended follow-up for failed tests) <br /> 87 A Master spill bucket has hole in lower side of bucket.Failed spill bucket test and will be repaired and retested by <br /> Elite V Contractors. <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 full compliance with legal requirements. <br /> e90-0.0p <br /> Signature of Technician: Date:8/26/10 <br />