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SECONDARY CONTAINMENTT I - REPORT FORM <br /> TESTING DATE: March 7, 2002 <br /> >' 1. OWNER INFORMATION <br /> Name Quik Stop Markets <br /> Contact Michael Karvelot Phone# (510) 657-8500 <br /> Address 4567 Enter rise Street, Fremont, CA 94538 <br /> 2. FACILITY INFORMATION <br /> Name Quik Stop#152 <br /> Contact Michael Karvelot Phone# (510) 657-8500 <br /> Address 1721-1 So. Cherokee, Lodi, CA 95240 <br /> 3. LOCAL AGENCY INFORMATION <br /> Name San Joaquin County Environmental Health Notified Feb 27, 2002 <br /> Contact Tank Team Phone# (209) 468-9847 <br /> Address 304 E. Weber Ave., Stockton, CA 95202 Fax# (209) 468-3433 <br /> Inspector Present <br /> ..... <br /> 4. TESTING CONTRACTOR INFORMATION <br /> Name Walton Engineering, Inc. Lie#/Class 617238 A, B, Haz <br /> Contact Michael Walton Phone# (916) 373-1152 <br /> Address P.O. Box 1025, West Sacramento, CA 95691 <br /> Test Technician James Da <br /> 5. SUMMARY OF TEST RESULTS <br /> Number of Tanks Tested 3 Number of Piping Runs Tested 3 <br /> Number of Piping Sumps Tested 3 Number of UDC Boxes Tested 2 <br /> Component Pass Fail Comments <br /> Annular-Tank#1 Gasoline-87 • O <br /> Annular-Tank#2 Gasoline-89 • O <br /> Annular-Tank#3 Gasoline-91 • O <br /> Secondary Pipe#1 Gasoline-87 • O <br /> Secondary Pipe#2 Gasoline-89 • O <br /> Secondary Pipe#3 Gasoline-91 • O <br /> Piping Sump#1 Gasoline-87 O • <br /> Piping Sump#2 Gasoline-89 O • <br /> Piping Sump#3 Gasoline-91 O • <br /> U D C#1 Disp#1/2 • O <br /> U D C#2 Disp#3/4 • O <br /> © 2002 Walton Engineering,Inc. <br /> 7 -n <br /> Technician Signature Date �7 ` l�- <br />