Laserfiche WebLink
Appendix 6 <br /> Underground Storage Tank <br /> Spill Containment Testing Report Form <br /> TESTING TYPE ❑ Installation ❑ Repair ✓❑ 12 Month <br /> 1. FACILITY INFORMATION <br /> CERS ID Test Date <br /> 10181361 06-09-2026 <br /> Facility Name <br /> TOP GAS <br /> Facility Address City ZIP Code <br /> 2057 SOUTH EL DORADO STREET �STOCKTON 95206 <br /> 2. SERVICE TECHNICIAN INFORMATION <br /> Company Performing Testing Phone <br /> ECO-CHEK Compliance Inc. 888-500-CHEK <br /> Mailing Address <br /> 3100 OAK ROAD , SUITE 205 -- WALNUT CREEK CA 94597 <br /> Service Technician Performing Testing <br /> Felix Ramirez <br /> Contractor License Number <br /> 08-1740 5/31/2026 <br /> ICC Certification ICC Expiration Date <br /> 8883072-UT 11/10/2026 <br /> 3. TRAINING AND CERTIFICATIONS <br /> Manufacturer and Test Equipment Training Certifications Training Expiration Date <br /> Franklin Fueling - EBW & Phil Tite #1009883708 3/24/2027 <br /> OPW#104634 3/11/2028 <br /> 4. TEST PROCEDURE INFORMATION <br /> Test Procedures Used Components Tested <br /> LAKE TESTING SPILL BUCKET , DRAIN VALVE AND ADAPTER <br /> 5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST <br /> I hereby certify that each spill containment was tested in accordance with California Code of <br /> Regulations, title 23, division 3, chapter 16, section 2664; that required supporting <br /> documentation is attached; and all information contained herein is accurate. I understand <br /> that test procedures must be made available upon request by the governing authority. <br /> Service Technician Signature Date Total # of Pages <br /> 106-09-2026 2 <br /> CERS = California Environmental Reporting System, ICC = International Code Council, <br /> ID = Identification <br /> Page 1 of 2 <br />