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belshire 25971 Towne centre Drive <br /> Foothill Ranch , CA 92610 <br /> environmental services, Inc. ( 949 ) 460-5200 <br /> Under Dispenser Containment Sump Integrity Testing <br /> Hydrostatic Testing Method <br /> Facility : Costco Wholesale - TRACY - 0658 Date : 9/24/2020 <br /> Address : 3250 W . Grantline Rd Testing Company : Belshire Environmental Services , Inc . <br /> City , State , Zip : Tracy , CA 95377 Tester Name : Jeff Badders <br /> This test is performed in accordance with PEI / RP1200 . See Section 6 .5 for the test method and procedures . <br /> Containment Sump ID 11 / 12 <br /> Exempt from Testing No <br /> Containment Sump <br /> manufacturer Environ <br /> Containment Sump <br /> material Plastic <br /> Liquid and debris <br /> removed from sump ?' Yes <br /> Visual Inspection" Pass <br /> Containment Sump <br /> Depth 34 " <br /> Height From Bottom to <br /> Top of Highest 11 " <br /> Penetration <br /> Test Start Time <br /> Starting Water Level <br /> Test End Time <br /> Ending Water Level <br /> Water Level Change <br /> Test Period 15 Minutes 15 Minutes 15 Minutes 15 Minutes 15 Minutes <br /> Pass/fail criteria : Must pass visual inspection . Water level drop of less than 0 .002 inches . <br /> Test Results: 01 Passim Fail a PassEJ Fail CA Pass [ Fail E) Pass [-]] Fail E PassE Fail <br /> Comments : <br /> 11 / 12 not tested due to bad test boot . <br /> `All liquids and debris must be disposed of properly . <br /> # No cracks, loose parts or separation of the containment sump . <br /> Technician Signature : r ' F ' �� ' Date : 9/24/2020 <br /> Rev. 9/28/2018 <br />