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-465-4988rty AGE 01/06 <br />12/09/2009 09:28 209 HMC <br />M. <br />DEC 0 9 2009 <br />SWRCB, Jsnuary2002 Page of <br />RAN J <br />Secondary Containment Testing Rep!_'- <br />Thisform is intendedfor use by. contractors performingpedodictaift of Uff secondary comm sysr ems Use the <br />appropriate pages qfthis form to report results for all components tested Me completed farm, written test procedures, and <br />printouts from tests (rf applicable), should be provided to the facility ownerloperatorfor submittal to the local regulatory agency. <br />L FACHITY MFORMATION., <br />Fm-hty Name 2VIK N STOP jDate -O-fTestas L.— 11-19-09 <br />Facility Address: 2057 S. EL DORADO, STOCKrON <br />Facility Contact- SINGH 463-6474 <br />Date IxAcal Agency Was MOW of Testing : <br />Name (if Local Aoncy Imector Opresent duriniz tes": <br />I <br />SUMURY Of TEST RESULTS <br />Elm <br />DISP 1-2 <br />MIMI <br />ir =5 77T -Arm i I i jj7, 7 7j t;.) 4,7777 777#1=7 7,77C,77T, 1*x : ,-J- 7-471 i 67V YI i 7 1771 <br />V 14 (OK"Y V flfl AV X44; 1 " y,1, IM A 1103, 01 trot 0 larlw 0, 1 <br />7=7M,r,77 -77 <br />