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SWRCR, January 2002 <br />Page 1 of 7 <br />Secondary Containment Testing Report For R E <br />Stockton Service Station Equipment Co., Inc. JAN 2 9 2004 <br />808 N. Union Street, Stockton, CA 95205-4152 (209) 464-8333 FAX (RQ9 9h <br />California Contractor License 309105 A -C61/1340 HAZ/HIC E-mail ssseco pacbelWM1T/SER,'v 1'_ ' <br />Facility Name: Stockton Auto Center Car Wash Date of Testing: January 27, 2004 <br />Facility Address: 3434 E. Hammer Lane, Stockton, CA <br />Facility Contact: Darrell Vinson Phone: 209.956.4040 <br />Date Local Agency Was Notified of Testing: <br />Name of Local Agency Inspector (if present during testing) <br />2_ TESTING CONTRACTOR INFORMATION <br />Company Name: Stockton Service S'taticm E uip:rent Co., I..c. <br />Technician Conducting Test: Russell Chadwick <br />Credentials: [X ] CSLB Licensed Contractor [ ] SWRCB Licensed Tank Tester <br />License Type: C -61/D40 HAZ/HIC License Number: 309105 <br />Manufacturer Training <br />Manufacturer Component(s) Date Training Expires <br />Smith Fiberglass Products Company N/A <br />tAM"05 10 F.111 ► ` 1 <br />Component Pass Fail Not Repairs Component Pass Fail Not Repairs <br />Tested Made Tested Made <br />Tank Annular Testing (Tank #I x <br />Tank Annular Testing Tank #2 X <br />If hydrostatic testing was performed, describe what was done with the water after completion of tests: <br />(Pages 3, 4, 5, 6, 7 N/A) <br />CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br />To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements. <br />Technician's Signature: Russell Chadwick Date: January 27, 2004 <br />NOTE: ORIGINAL MAILED TO MR. RAY VON FLUE, with SAN JOAQUIN CO. <br />ENVIRONMENTAL HEALTH DIV. <br />