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SWRCR,January 2002 <br /> Y Page 1 of 7 <br /> Secondary Containment Te 9 <br /> 1 / fi <br /> Stockton Service Station Equipment Co., nc. <br /> 808 N. Union Street, Stockton, CA 95205-4152 (209) 464-8333 FAX (209) 464-8349 <br /> California Contractor License 309105 A-C61/D40 HAZ/HIC E-mail sssecoL&pacbell.net <br /> 1. FACILITY INFORMATION <br /> Facility Name: United Parcel Service Date of Testing: May 8,2009 <br /> Facility Address: 1532 N.Broadway,Stockton,CA 95205 <br /> Facility Contact: Herman Meyer Phone: 916.599.3424 <br /> Date Local Agency Was Notified of Testing: May 6,2009 <br /> Name of Local Agency Inspector(if present during testing) Jeff Won <br /> 2. TESTING CONTRACTOR INFORMATION — <br /> Company Name: Stockton Service Station Equipment Co.,Inc. <br /> Technician Conducting Test: Mike Jones,ICC 525644-UT <br /> Credentials: [X] CSLB Licensed Contractor [ ] SWRCB Licensed Tank Tester <br /> License Type: C-61/D40 HAZ/HIC License Number: 309105 <br /> Manufacturer Training <br /> Manufacturer Component(s) Date Training Expires <br /> 3. SUMMARY OF TEST RESULTS _ <br /> Component Pass Fail Not Repairs Component Pass Fail Not Repairs <br /> Tested Made Tested Made <br /> Secondary Pipe Testing, Page 3 x <br /> Piping Sump Testing, Page 4 x <br /> Under-Dispenser Containment Pg 5 x <br /> Spill/Overfill Containment Pg 7 x <br /> If hydrostatic testing was performed,describe what was done with the water after completion of tests: <br /> 1. TWO 55-GALLON DRUMS,LABELED LEFT ON SITE FOR CERTIFIED WASTE HAULER <br /> 2. PAGES 2 AND 6 N/A <br /> TEST RESULTS MAILED TO: JEFF WONG,SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DIST and <br /> HERMAN MEYER,UNITED PARCEL SERVICE <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: -Mike .Tones Date: May 8,2009 <br />