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r*UF.IVED <br />WRCB, January 2006 <br />Spill Bucket Testing Report Fa <br />Rvi <br />This for•rn i.e i ... ended for use by contractors performing annual testing of UST spill coWlawneeand <br />pr•intoa1�s /1,oIn tens (if opplicable), should be provided to the facility owner/operator for submittal tWte ajVZ1etdfbrm <br />ory agency. <br />L FACILITY INFORMATION <br />Facility Name: SIT]LL Date of Testing: 02-11-15 <br />Facility A(Wress: 2320 EL DORADO STOCKTON CA <br />Facility Contact: Phone: <br />Date Local A-encv Was Notified of Testing:11-21-15 <br />Name of Locad Agency Inspector (lfpresent during testing): SJC <br />2. TESTING CONTRACTOR INFORMATION <br />Com1-any Name: AFFORDA TEST 4162"d Street Galt, CA 95632 (209) 744-0112 Fax: (209) 744-0116 <br />Technicia^ Conduciin_, Test: ❑ Lyle D. Nimmo ❑ Zane A. Nimmo ® David A. Winkler ❑ Felix G. Ramirez <br />5249115 -UT 5263322 -UT 5263373 -UT 5273934 -UT <br />Craicntia�': (� I C Service Tech. ❑ S\\'R(7R Tank Tester <br />3. SPI T ,1, III W l®!JT TESTING INFORMATION <br />-t��d: ®Hydrost <br />Us.c1: h''0 and tape measure <br />tic ❑ Vacuum ❑ Other <br />Resolution 1/16 <br />L,nl,��l <br />87 <br />2 91 3 DSL <br />- <br />4 <br />I i o(lri(,r, etc.) <br />_- <br />®Direct Bury <br />Direct Bury <br />I� �I�t Inst!I<tion "lyre: <br />❑ Direct Bury <br />®Direct E3ury <br />❑Contained in <br />E] Contained in <br />El Contained in Sump <br />ElContained in Sump <br />SumpSum <br />Pket Di ..cr: <br />11 <br />I I 11 <br />13 <br />13 13 <br />\\ it time I cup ; ;yine <br />Tess Start " c (T,; ��� <br />1020 <br />11)?0 1020 <br />12 3/4 <br />12 12 <br />n F': <br />1120 1120 <br />12 ', /4 <br />12 12 <br />�u <br />IHR <br />111R IHR <br />,c in c,Wi1, !RF -R,): <br />1 0 <br />0 0 <br />l ail I r_ cIJ c�i <br />1/16 <br />1/16 1/16 <br />t '2cs T <br />�� Pass] Fai! <br />® P° Iss ❑;Fail ®Pass ❑ Fail <br />❑Passe ❑Fait <br />b;,rvr1nn1i0n on rant%r, mn(le pri�)r in tasting and recommendedfollow-upforfailed tests) <br />KFSI'O^•` MLL FOR CONDUCTING THIS TESTING <br />crntained in thi, report is true, accurate, and in full compliance with legal requirements. <br />Date 02-11-15 <br />'I" la,, ",{ r i ions do not currently rr-mjire testing to be lierformed by a qualified contractor. However, local requirements <br />