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+. G - I vii <br />Hfiffl <br />R CUd}t�z5a 5XC <br />v �'kd9§7b s�4:. SF z..n7 <br />Page I <br />`econdary Containmentc OverfiH Containment <br />Testing Report 1 <br />!' 1 <br />Facility Name: Verizon - KINGCA Date of 9/13/07 <br />Facility Address: 13850 Devries Kingdon, CA. <br />Facility Contact: Leo Cabatu Phone: 925-951-2020 <br />Date Local Agency Was Notified of Testing: 9/11/07 <br />Name of Local Agency Inspector (f present during testing): Tuoa Yang <br />Company Name: <br />Balch Petroleum Contractors & Builders, Inc. <br />Technician Conducting Test: Elmer Mortera <br />Credentials: <br />X CSLB Licensed Contractor ❑ SWRCB Licensed Tank Tester <br />License Type: A / B / C -IO / HAZ License Number: 396575 <br />Manufacturer Training <br />Manufacturer Component(s) Date Training Expires <br />Ronan <br />Hydrostatic Precision Test Equipment NA <br />Caldwell <br />Hydrostatic Precision Test Equipment NA <br />t U JUF : 1 <br />Component <br />Pass Fail Not <br />Tested <br />Repairs <br />Made <br />Component Pass Fail <br />Tested <br />Not <br />Repairs <br />Made <br />Tank Annular <br />X ❑ <br />❑ <br />El <br />Secondary FOS <br />X ❑ ❑ <br />❑ <br />❑ ❑ <br />❑ <br />❑ <br />Secondary FOR <br />X <br />Secondary Vent <br />X ❑ ❑ <br />1 ❑ <br />Overspill Bucket <br />X ❑❑ <br />❑ <br />El <br />11 <br />Vent Transition Sump <br />X ❑ <br />❑ <br />j <br />❑ <br />Piping Transition Sump <br />X 7❑ <br />❑ <br />Fill Sump <br />X ❑ - <br />❑ _ <br />❑ ❑ ❑ <br />❑ <br />i❑ ❑ <br />❑ <br />❑ <br />Ll 11 <br />E <br />❑ ❑ ❑ <br />- <br />❑ I <br />❑ <br />❑ <br />- ❑ <br />❑ <br />r, <br />❑ <br />ii.1 <br />Notes: <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: oll, Date: 9/13/07 <br />I:\apps\JOBS\2007\S01289.KINGCA\SB989 KINGCA.doc <br />