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• • <br /> RECEIVED P.O.Box 4208 <br /> Sonora CA 95370 <br /> AjjteChpetrAa'r (� Ca 623541 A-Haz <br /> �R1 C 2 2018 Phone:209-532-7320 <br /> Compliance without Compromise Fax:209-533-2650 <br /> ENVIRONMENTAL HEALTH mail@alltechpetro.com <br /> PERMIT/SERVICES www.alitechpetro.com <br /> Spill Bucket Testing Report Form <br /> FACILITY INFORMATION: <br /> Facility Name: Hammer 1-5 Arco Date of Testing: Thursday, May 07, 2015 <br /> Facility Address: 3201 W. Hammer Lane Stockton CA <br /> Facility Contact: Wes Parkinson Phone: (209) 474-9125 <br /> Notification Date of Local Agency: 04/29/15 <br /> Name of Local Agency Inspector: Stacy Rivera <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 Syphon 2 87B Master 3 91 4 <br /> Bucket Installation Type: ❑ Direct Bury ❑ Direct Bury ❑ Direct Bury ❑ Direct Bury <br /> ® In Sump ® In Sump ® In Sump ❑ In Sump <br /> Wait time between <br /> applying vacuum/water None None None <br /> and start of test: <br /> Test Start Time (T,): 10:30 am 9:00 am 10:30 am <br /> Initial Reading (R,): 3" above cap 1.5" above cap 2" above cap <br /> Test End Time(TF): 11:30 am 10:00 am 11:30 am <br /> Final Reading (RF): 3" above cap 1.5" above cap 2" above cap <br /> Test Duration (TF—T,): 1.0 Hr 1.0 Hr 1.0 Hr <br /> Change in Reading (RF-R,): 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 <br /> tests) <br /> 87 Syphon spill bucket and 91 spill bucket failed first test. Repaired and retested, passed on second test. <br /> CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br /> 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: Date: 05/07/15 <br />