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P.O. Box 4208 <br />Sonora CA 95370 <br />AliteCa: 623541 A-Haz <br />c® Phone: 209-532-7320 <br />Compliance without Compromise Fax: 209-533-2650 <br />mail@alltechpetro.com <br />www.alltechpetro.com <br />Spill Bucket Testing Report Form <br />CArll ITV 1n1MRnneTInA1- <br />Facility Name: Hammer 1-5 Arco Date of Testing: Thursday, May 30, 2013 <br />Facility Address: 3201 W. Hammer Lane Stockton CA <br />Facility Contact: Wes Parkinson Phone: (209) 474-9125 <br />Notification Date of Local Agency: 5/7/13 <br />Name of Local Agency Inspector: Garrett Backus <br />con I RI Irk r -T TFCTIIUG IAIFnRMAT1nN- <br />Test Method Used: ® Hydrostatic ❑ Vacuum ❑ Other <br />Test Equipment Used: 1 -Hour Observed Test <br />Equipment Resolution: 1/16" <br />2 87B Master <br />3 91 4 <br />Identify Spill Bucket <br />1 87A Syphon <br />Bucket Installation Type: <br />❑ Direct Bury <br />® In Sump <br />❑ Direct Bury <br />® In Sump <br />❑ Direct Bury ❑ Direct Bury <br />® In Sump ❑ In Sump <br />Wait time between <br />applying vacuum/water <br />and start of test: <br />None <br />None <br />None <br />Test Start Time (T,): <br />12:40 <br />12:40 <br />12:40 <br />Initial Reading (R,): <br />3 1/2" above cap <br />2 3/4" above cap <br />1 5/8" above cap <br />Test End Time (TF): <br />13:40 <br />13:40 <br />13:40 <br />Final Reading (RF): <br />3 1/2" above cap <br />2 1/4" above cap <br />1 5/8" 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 />Criteria: <br />1/16" <br />1/16" <br />1/16" <br />Test Result: <br />Z Pass ❑ Fail <br />❑ Pass ® Fail <br />® Pass ❑ Fail ❑ Pass ❑ Fail <br />Comments — (include information on repairs made prior to testing, and recommended follow-up for failed <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 <br />legal requirements. <br />Signature of Technician: ECEIVEDDate. 5/30/13 <br />JUN 0 5 2013 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />