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Appendix Vill <br /> Underground Storage Tank <br /> Spill Container Testing Report Form <br /> TYPE OF ACTION C] Jnstallation 0 Repair ® 12 Month <br /> 1. FACILITY INFORMATION <br /> OERS ID Test Date <br /> 10399867 <br /> Facility blame <br /> Hunt& Sons LL <br /> Facility Address City ZIP Code <br /> 4733 S. Hwy 99 Frontage Rd Stockton 95201 <br /> 2. SERVICE TECHNICIAN INFORMATION <br /> Company Performing the Test Phone <br /> Hunt Equipment LI..0 09-537-9396 <br /> Mailing Address <br /> 2825 Railroad Ave Deres CA. 96307 _ <br /> ervioe Technician Performing Test <br /> Gerardo Perez <br /> Contractor/Tank Tester License Number <br /> 1018253 <br /> ICC Number ICC Expiration Date <br /> 10250519 1315127 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer and Test Equipment Training Certifications Expiration Date <br /> feeder Foot 31217 <br /> OPW 31 20127 <br /> 4. TEST PROCEDURE INFORMATION <br /> Test Procedures Used Components Tested <br /> 6, CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br /> $ hereby certify that each spill container was tested In accordance with California Carle of <br /> Regulations, title 23, division 3, chapter 16, section 263 7.1 that required supporting <br /> documentation is attached; and all information contained horain is accurate. l understand <br /> that test procedures shall be made available upon request by the grouerning amtlaerify. <br /> Service Tech nici ignature Date Total # of Pages <br /> CERS = al ornfa Environmental Reporting System, ID = Identification, ICC = International Code <br /> Council <br /> Page 1 of 2 <br />