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Apr 2417 02:29p P.8 <br /> 04/I8/2017 21:32 91691073 ARCADISO is PAGE 02 <br /> page of <br /> Secondary Containment Testing Report Form <br /> his form is fniendedfor use by CoMractOrs perfornd"periodic testbW of USTseconiary containment systems. Use the <br /> *#Mprjpjrpages of jhj,,rform f*report rgsuW.fbraUcw7qwneMfs tested. The COMPIM00 r <br /> forint w rittenlestp vc&*wes,and <br /> 1. FACILITY INFORMATION <br /> Focility Name' sincloiir of Terdng,. 9/29*016 <br /> Facility Address' 7906 K M Dorado Sawt Stockton,CA 952 10 <br /> Facility Cot tact: Site Manager Phone: 209-657-2997 <br /> Date Local Agency Was Notified of TeWDS: 9123r-016 <br /> NanX of Local Agency jnspectortifpresenl during testing): n/A <br /> 2. U577NG CONTRACTOR INFORMAMON <br /> Company Name: pimmele fuel Com E!!!tux scrvkev,,Inc. <br /> Technician Conducting Test: Ancil Chwd ICC M-5119959 UT <br /> Credcatiids- x Licensed Contractee X Licen3ed Tank Tester <br /> Liccose Ty e: CSL8 894912 License Number.SWRB 90-1262 <br /> Manufacturer Convonerd(s) Deft Trelrd2g Expites <br /> Caldwell Level ludicator IN2017 <br /> ICC California UST Service Tediniciamt W04-2018 <br /> 3.- SUMMARY OF TEST RESULTS <br /> c4mpment Pas Fail Not RIZP140 ConTostent Pass FRO I Not Repsgrs <br /> Tested Mads Tested Made <br /> Super AnnularTK#4 _j Super STP Stem2 TK#4 <br /> RcRular Annular TK#lWest I H Regular STP SuLnp T <br /> Re )ar Annular 702Cepta Rcjmlw piping Sump TK#2 19 Ll I I <br /> geLular Annular TKOFast. lite alar STP SUMP TK*3 r # <br /> VPC 1-2 Surnp <br /> [Sudary fuel line <br /> E 7 <br /> UPC 3-4 SuMp 11 0 Regular seamdary fuel line <br /> MC 5-6 Sump Regular secondary fael line, <br /> .UJDC 7-8 suln Rc lar cross over line <br /> "Uper Fill Sum TK#4 <br /> Regular Fill§umTV,A I Lj I D D-1 <br /> 2 <br /> Regular Fill Sump TK#2 El M <br /> Re uJor Fill SME TK#3 <br /> PAGE-1 <br /> Now;vict kod of p;0vt nn is)kaiv;could not be established due to the fai the <br /> ,oyx r ten bout inside dispen*oM 1.2 has been pulled out or Wi top homdar..Piping <br /> and shtshov.%The diNPUMM have J031 b=reloweed*his 4003t of btppfttd when <br /> W.-Aajlw4&being c 3UPER LINE AT THIS TIME <br /> CERTIFICATION OFTECHNICL4,N RMPONSIBLE FOR CONDUCTING THIS nSTMG <br /> Tk.W beg of my knowledge,the faxGc seared in this doewma#arc accurate and infW1 compRaiuv with kgW requIremeno <br /> eN <br /> Te+ bnician'$Sigratme. Date:9/29/7016R E C., <br /> v <br /> A'PR 2 4 <br /> H <br /> -4 E'A J <br /> ENVIFIONMEN TAL <br /> 'E VT <br /> C,11,,0A,9`,,,,;'j__ <br />