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2560 Soquel Avenue Ste 02 <br />Santa Cruz CA 95062 <br />T: 831.475.8141 <br />F: 831.475 * 8249 <br />CA Lic# 693807 A-HAZ B-HIC <br />- Ap- <br />M11MrT <br />�CONSTRUCTION J <br />Secondary Containment Testing Report Form <br />I 1pneillift Irinfarl"0*1*1rin <br />Facility Name: Valero 3641 <br />Date of Testing: 07/08/2008 <br />Facility Address: 1210 Hammer Ln Stockton CA. 95210 <br />Facility Contact- <br />Phone: 209-477-3111 <br />Date Local Agency Was Notified of Testing : 07/03/2008 <br />Name of Local Agency Inspector (if present during testing): <br />2. Testing Contractor Information <br />Manufacturer Component Expiration Date <br />3. Summary of Test Results <br />Is this a retest of previously failed components? 1:1 YES <br />Component <br />P <br />I F I <br />NT <br />r RM <br />Component <br />P <br />F <br />I NT <br />7:T <br />RM <br />Spillbox: All <br />9 <br />El <br />El [1 <br />0 <br />El <br />11 <br />El <br />Annulars: All <br />El <br />El El <br />0 <br />0 <br />0 <br />0 <br />Secondary Piping: All <br />0 <br />0 0 <br />0 <br />0 <br />0 <br />0 <br />Fill sumps: All <br />0 <br />El El <br />11 <br />1:1 <br />El <br />171 <br />Turbine Sumps: All <br />IN <br />El <br />El El <br />El <br />El <br />E] <br />El <br />UDCs: All <br />19 <br />0 <br />1:1 El <br />El <br />13 <br />E3 <br />El <br />EI <br />171 <br />E3 E3 <br />El <br />R <br />11 <br />El <br />11 <br />1-71 <br />El El <br />11 <br />El <br />El <br />0 <br />CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING <br />To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements <br />Technician's Signature: Date: 07/0812008 <br />Technician's Name: ran <br />1 of 7 <br />