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UNDERGROUNDSTORAGETANK <br /> SPILL CONTAINER TESTING , • - - t , <br /> f <br /> Type of Action Installation Test 0 Repair Test <br /> © 12 Month <br /> FACILITY INFORMATION- i • <br /> CERS • <br /> Date of Spill Container Test <br /> 10181251 <br /> • I • <br /> Business Name (Same as Facility Name . • : Doing Business As) <br /> CANEPA'SA * WASH <br /> BusinessAddress <br /> city - Code <br /> ' 6230 PACIFIC AVE <br /> STOCKTORCA .95207 <br /> Lll - <br /> • aTwn <br /> MAITA hrl / • 1 <br /> 1 12 <br /> Contractor I Tank Tester License # rImf4if1^nf 57 <br /> ICC Certification Expiration Date <br /> M1739 / : : : i • 1 /29/2020 <br /> • . <br /> Franklin Fueling EBW & Phil Tite # 10009853708 Ex. 11 /29/20 <br /> • ' 04 020 <br /> CONTAINERIlia SPILL TESTING INFORMATION <br /> MethodTest Used: Z Manufacturer Guidelines (Specify): WATER <br /> ■ Industry Codeor Engineering Standard <br /> ■ Engineered Method <br /> procedures # of Attached Pages <br /> Attach the testing d alf documentation required todetermine <br /> TANK ID: (By tank number stored product, etc.) <br /> Spill Container Manufacturer <br /> Method of Cathodic <br /> 1 • p NonwMetallic NonWetallic1 • - <br /> tallic <br /> ■ IsolationIsolation 0 Isolation El Isolation <br /> ■ • ■ • ■ Other <br /> Inside Diameter of Spill Container (Inch <br /> . 1 • - - • • • • • E3 NJ Drain Valve • - - <br /> ■ • , ■ • • ■ Onsite Pump ■ • <br /> ■ • ■ • ■ • (specify <br /> ELMEM <br /> • <br /> Lit tug <br /> - r . rr • - - r - • • . rr r r <br /> r r ' r r • • r <br /> • - MIN • <br /> • 0 1 • - - . • • 1 ✓. � •- • - • . 1 • . • - � • • a •- <br />