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KECE <br /> S 2 B,January 2 <br /> Spill Bucket Testing Report For APR 18 2008 <br /> This form is intended for use by contractors performing annual testing of UST spill containment structur&1'l1V,&qvPjqFW,,rm and <br /> printouts from tests(if applicable),should be provided to the facility ownerloperatorfor submittal to the WTMiWatow,'VACY. <br /> 1. FACILITY INFORMATION J&,ARTUE N-r <br /> Facility Name: TRACY TRUCK AND AUTO STOP Date of resting: 3/26/08 <br /> Facility Address: 3940 N.Tracy Blvd Tracy Ca.95376 <br /> Facility Contact: Debbie Jutla Phone: (209)832-5006 <br /> LDate Local Agency Was Notified of Testing: 3/05108 <br /> Name of Local Agency Inspector(ifpresent during testing): Michelle Henry <br /> 2. TESTING CONTRACTOR INFORMATION <br /> Company RELIABLE PETROLEUM SERVICES INC. <br /> Technician Conducting Test: Guadalupe Sanchez <br /> Credentials': X CSLB Contractor X ICC Service Tech. 0 SWRCB Tank Tester 0 Other(Specify) <br /> License Number(s): 883706 5250451-UT <br /> 3. SPILL BUCKET TESTING INFORMATION <br /> Test Method Used: X Hydrostatic 0 Vacuum 0 Other <br /> Test Equipment Used: Standard Tape Measure Equipment Resolution: <br /> Identify Spill Bucket(By Tank Tl:87 Unleaded T1:91 Supreme T3:Diesel 2 West T4:Diesel 2 East <br /> Number, Stored Product, Fill Fill Fill Fill <br /> Bucket Installation Type: X Direct Bury X Direct Bury X Direct Bury X Direct Bury <br /> Contained in Sump Contained in Sump Contained in Sump Contained in Sump <br /> Bucket Diameter: Bucket is broken and 12" 12" 12" <br /> Needs to be replaced. <br /> Bucket Depth: Not tested 133/4" 12 13 <br /> Wait time between applying 1 min. 1 min. 1 min. <br /> vacuum/water and start of test: <br /> Test Start Time(TI): 9-32a.m 9-.31a.m 9:30a.m <br /> Initial Reading(Rj): 9 1/16" 11" 7 11/16" 1 <br /> Test End Time(TF): 10:55a.m 10:55a.m 9:42a.m <br /> Final Reading(RF): 9 1/16" 11" 7 1/16" <br /> Test Duration(TF—Ti): 1hr.23min. 1hr.24min. 12 min. <br /> Change in Reading(RF-RI): 0 0 5/899 <br /> Pass/Fail Threshold or 1/16" 1/16" <br /> Criteria: <br /> Test Result. Pass X Fail X Pass Fail X Pass Fail Pass X Fail <br /> Comments—(include information on repairs made prior to testing, and recommended follow-up for failed tests) <br /> Repaired T4: Diesel 2 East fill box(reWaced fill adapter P-asket & fill can reseal <br /> The 4" nipple and retested — Test passed — will schedule for a witness test with <br /> inspector <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 /> Technician's Signature <br /> Date: 3126/08 <br /> State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements <br /> may be more stringent. <br />