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Spill Bucket Testing Report Form
Thisform is intendedfor use by contractors performing annual testing of UST spill containment structures. The completed fawn and
printouts from tests (ifapplicable), should be provided to thefacility owner /operatorforsubmittal to the local regulatory agency.
FACILITY INFORMATION Facility ID: CAK010
Facility Name: AT &T Corporation Date of Testing: 5/18/2012
Facility Address: 1520 20TH ST, BAKERSFI ELD, CA 93301
Facility Contact: Grant Armstrong Phone: 661- 327 -6903
Date Local Agency Was Notified of Testing: 5/9/2012
Name ofLocal Agency Inspector (ifpresent during testing): Ernest Medina
TESTING CONTRACTOR INFORMATION
Company Name: TAIT Environmental Services, Inc.
Technician Conducting Test: Stephen Graham
Credential I : r CSLB Contractor ICC Service Tech. SWRCB Tank Tester r Other (Specify)
License number(s): A B ASB C -10 HAZ License Number 588098 : 5240926
SPILL BUCKET TESTING INFORMATION
TestMethod Used: Hydrostatic r Vacuum r Other
Test Equipment Used: Marker and tape measure Equipment Resolution: 1/16"
Identify Spill Bucket (By Tank
Number, Stored Product,etc. ) 1 CAKOl0U001
Bucket Installation Type: f— Direct Bury
F Contained in Sump
r On top of AST
F Direct Bury
F Contained in Sump
r On top of AST
r Direct Bury
r Contained in Sump
r On top of AST
r Direct Bury
f— Contained in Sump
r On top of AST
Bucket Diameter: 12.5"
Bucket Depth: 181,
Wait time between applying
vacuum /water and start of test:
15 minutes
Test Start Time (Tl): 10:00 am
Initial Reading (RI): 15.0"
Test End Time (TF): 11:00 am
Final Reading (RF): 15.0"
Test Duration (TF —Tl): 1 hour
Change in Reading (RF -Rl): 0"
Pass /Fail Threshold or
Criteria:
0..
Test Result: F Pass r Fail r Pass r Fail r Pass r— Fail r Pass r Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -up for failed tests)
All water returned to Tait shop.
CERTIFICATION OFTECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
hereby certify that all the information contained in this report is true, accurate, and in full compliance with legal requirements.
Technician's Signature: Date: 5/18/2012
d TAP T
c,sinc ,o me cnnuta .t
p:714'S60i8222 ww.toit _0-r.
May 22, 2012
VIA FED EX: 7984 2348 4986
Bakersfield Fire Department
2101 H Street
Bakersfield CA 93301
Re: Spill Bucket Testing
AT &T Corporation
1520 20th STREET, BAKERSFIELD, CA
GEOPAR: CAK010
To Whom it May Concern:
2.13! 5 Dupont fkn -e. Anahonn, CA 9:,806
Enclosed are the results for the following tests completed on May 18, 2012:
Spill Bucket Testing Report Form
Please do not hesitate to call me if you have any questions.
ViheWwL.
l rs,
M Denison
Program Manager
CA cN 586098 , A2 1,C,- 095984 r NV I C 0049666 TX uca CR0000041