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TRI-ANNUAL SECONDARY CONTAINMENT TEST <br /> TEST DATE: December 22, 2004 <br /> 1. OWNER <br /> Name Quik Stop Markets, Inc. <br /> Address 4567 Enterprise Street, Fremont, CA 94538 Phone# 510-657-8500 <br /> Contact Michael Karvelot <br /> 2. FACILITY <br /> Name Quik Stop Market#39 <br /> Address 2289 E. Fremont Street, Stockton, CA 95205 Phone# 510-657-8500 <br /> Contact Michael Karvelot <br /> 3. CUPA <br /> Name San Joaquin County Environmental Health Notified December 16,2004 <br /> Address 304 E Weber Avenue 3rd Floor, Stockton, CA 95202 Phone# 209-468-9847 <br /> Contact Tank Team Fax# 209-468-3433 <br /> Inspector Present None <br /> 4. TESTING CONTRACTOR <br /> Name Walton Engineering, Inc. Lic# 617238 A, B, Haz <br /> Address P.O. Box 1025, West Sacramento, CA 95691 Phone# 916-373-1152 <br /> Contact Michael Walton Fax# 916-373-1172 <br /> Test Technician David D ess <br /> 5. SUMMARY OF TEST RESULTS <br /> Tank Annulars Tested 0 Containment Sumps Tested 2 <br /> Secondary Lines Tested 2 UDC's Tested 2 <br /> Component Results Component Results <br /> Annular-Tank#1 Gasoline-91 Piping Sump#1 Gasoline-91 Pass <br /> Annular-Tank#2 Gasoline-87 Piping Sump#2 Gasoline-87 Pass <br /> Secondary Line#1 Gasoline-91 _ Pass U D C#1 Disp#1/2 Pass <br /> Secondary Line#2 Gasoline-87 Pass U D C#2 Disp#3/4 Pass <br /> 6. COMMENTS <br /> Technician Signature ��� �� Date <br /> © 2004 Walton Engineering,Inc. <br />