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„ . ,iie >. <br /> UNDERGROUNDSTORAGETANK <br /> SPILL CONTAINER <br /> Type of . El Installation Test <br /> ■ Repair <br /> FACILITY INFORMATION <br /> CERS ID <br /> Date of Spill <br /> 10181251 <br /> 6/3/2019 <br /> Business Name (Same as Facility Name or DBAiiiiDoing Business As) <br /> CANEPAS A . WASH <br /> AddressBusiness Site <br /> City ZIP• i • , <br /> STOCKTORCA <br /> • i <br /> UNDERGROUNDlie • RAGE TANK SERVICE TECHNICIAN INFORMATION <br /> Name • f LIST service Technician . . - <br /> Phone # <br /> DAVE WINKLER <br /> (209) 744111110l 12 <br /> Contractor / Tank Tester License # <br /> • • "TCC . . <br /> . . <br /> . . <br /> : 1 /29/2020 <br /> FuelingSpill Container Testing Training and Certifications (List applicable certifications.) <br /> Franklin EBW & Phil Tile #10009853708 1 <br /> ' OPW #104111113/14/2020 <br /> ills SPILL CONTAINER INFORMATION <br /> . • <br /> Test . , I <br /> 'ffl'ndustry Code or Engineering Standard (Specif <br /> ■ Engineered Method <br /> MethodAttach the testing procedures and all documentation required to determine the results. # of Attached Pages' <br /> TANK I D: (By tank number stored product, etc.) r <br /> Spill Container Manufacturer <br /> of . , <br /> ■ Isolation ■ Isolation 1 ■ IsolationIsolation <br /> III IIIIIIIIIfIIIII ne IF (specify in 7.) 11i <br /> E3 Fq <br /> • fillcilk- <br /> r r , r . . rr % . , , r rr • . . r r <br />