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r <br /> Alltech Petro Inc. <br /> 17759 Buttercup Circle, Sonora, CA 95370 <br /> Phone: 209-532-7320; Fax: 209-533-2650 <br /> California Contractor 623541 A-Haz <br /> ailtechmail@mac.com I]:% I <br /> Spill Bucket Testing Report Form <br /> FACILITY INFORMATION: <br /> Facility Name: Arco Date of Testing: 8/18/2008 <br /> Facility Address: 3201 W.Hammer Lane Stockton CA <br /> Facility Contact: Wes Parkinson Phone: (209)474-9125 <br /> Notification Date of Local Agency: <br /> Name of Local Agency Inspector:Michelle Henry <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 /> Identify Spill Bucket 1 87A 2 87B 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): 9:00 9:00 9:00 <br /> Initial Reading(RI): Top of Cap Top of Cap Top of Cap <br /> Test End Time(TF): 10:00 10:00 10:00 <br /> Final Reading(RF): Top of Cap Top of Cap Top of Cap <br /> Test Duration(TF—Tj): 1.0 Hr 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 Resul 1 ® Pass ❑Fail 1 ® Pass ❑Fail 1 ® Pass ❑Fail ❑ Pass ❑Fail <br /> Comments—(include information on repairs made prior to testing, and recommended follow-up for failed tests) <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 /> Signature of Technician: Date: 8/18/2008 <br /> Certification:' ICC UST Technician#8005930-UT. Expires: 6/14/2010 <br /> Veeder Root#B36878 ISD Expires: 8/14/2010 <br />