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P.O. Box 4208 <br />Sonora CA 95370 <br />Ca: 623541 A-Haz <br />rArn 9Tv 1KIMPUATIMP <br />Facility Name: Hammer 1-5 Arco Date of Testing: Thursday, May 29, 2014 <br />Facility Address: 3201 W. Hammer Lane Stockton CA <br />Facility Contact: Wes Parkinson Phone: (209) 474-9125 <br />Notification Date of Local Agency: 5/15/14 <br />Name of Local Agency Inspector: Stacy Rivera <br />cpu I RI IrICFT TFiTING INFORMATION - <br />Test Method Used: <br />® Hydrostatic <br />❑ vacuum <br />❑ Other <br />Test Equipment Used: 1 -Hour Observed Test <br />Equipment Resolution: <br />1/16" <br />.=„�... ... ,._. U a ,,,. ,, ,,,g. . <br />Identify Spill Bucket <br />1 87A Syphon <br />2 87B Master <br />3 91 <br />4 <br />r_1 Direct Bury <br />❑Direct Bury <br />❑ Direct Bury <br />—1 Direct Bury <br />Bucket Installation Type: <br />® In Sump <br />® In Sump <br />® In Sump <br />In Sum <br />Wait time between <br />applying vacuum/water <br />None <br />None <br />None <br />and start of test: <br />Test Start Time (T): <br />9:00 <br />9:20 <br />10:50 <br />Initial Reading (R,): <br />1 5/8" above cap <br />4" above cap <br />3 9/16" above cap <br />Test End Time (TF): <br />10:00 <br />10:20 <br />11:50 <br />Final Reading (RF): <br />1 5/8" above cap <br />4" above cap <br />3 9116" above cap <br />Test Duration (TF — T,): <br />1.0 Hr <br />1.0 Hr <br />1.0 Hr <br />Change in Reading (RF -R,): <br />0.0 <br />1/2 inch <br />0.0 <br />Pass/Fail Threshold or <br />1/16" <br />1/16" <br />1/16" <br />Criteria: <br />Test Result: <br />® Pass ❑ Fail <br />I ❑'' <br />Pass ® <br />Fail <br />Z Pass ❑ Fail1,E]_Pass <br />C,] Fain <br />Comments — (include information on repairs made prior to testing, and recom <br />CERTIFICATION OF TECHNICIAN RESPONSI <br />I hereby certify that all the information contained in th <br />legal requi <br />Signature of Technician: SUN <br />