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UNDERGROUND STORAGE TANK SECONDARY CONTAINMENT TESTING REPORT Type of Action : ❑ Installation Test ❑ Repair Test ® 36 Month Test I . FACILITY INFORMATION CERS ID Date of Test: 3/27/2019 Business Name : Chevron- Lathrop Site Address : City Zip Code 444 Mossdale Lathrop II . UNDERGROUND STORAGE TANK SERVICE TECHNICIAN INFORMATION Name of UST Technician : Phone # : Vic Arneson 916-693-0555 Contractor License # : ICC Certification ID : T12/27/2021 Expiration Date : 433159 8709495 III . SUMMARY OF SECONDARY TESTING RESULTS TANK ID : A 87 B 91 C DSL D Tank Containment (Annular) Tightness Test Results ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA Product Piping Containment (Sec Line) Tightness Test Results ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA Communication Test Results ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA Remote Fill Piping Containment Tightness Test Results ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ❑ NA Communication Test Results ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ❑ NA Vent Piping Containment Tightness Test Results ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA Communication Test Results ® Pass ❑ Fail ❑ NA ® Pass ❑ Fall ❑ NA ® Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA Vapor Recovery Piping Containment (Sec) Tightness Test Results ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ❑ NA Communication Test Results ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ❑ NA Turbine/Product Piping Sump (STP) Tightness Test Results ❑ Pass ® Fail ❑ NA ® Pass ❑ Fail ❑ NA ❑ Pass ® Fail ❑ NA ❑ Pass ❑ Fail ❑ NA Fill Riser Sump Tightness Test Results ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ® NA ❑ Pass ❑ Fail ❑ NA VENT/TRANSITION SUMP ID : a b c d Tightness Test Results ❑ Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA UDC ID : 1 1/2 2 3/4 3 5/6 4 7/8 Tightness Test Results ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA UDC ID : 5 9/10 6 11/12 7 8 Tightness Test Results ® Pass ❑ Fail ❑ NA ® Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA UDC ID : 9 10 11 12 Tightness Test Results ❑ Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA ❑ Pass ❑ Fail ❑ NA All Items marked "Fail" or "NA " must be explained in their respective "Comments section IV. CERTIFICATION BY UST SERVICE TECHNICIAN CONDUCTING THIS TESTING I hearby certify that the secondary containment was tested in accordance with California Code of Regulations, Title 23, Division 3, Section 2637 and all the information contained herein is accurate UST ServiceTechnicianSignature V/� ' L