HomeMy WebLinkAboutUST APPLICATION 12-2015UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD I LINE TESTING
/ SB989 SECONDARY CONTAINMENT TESTING
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO. I a I
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING
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❑ SB-989 SECONDARY CONTAINMENT TESTING
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SITE INFORMATION
FACILITY ARCO
RE
BAKERSFIELD FIRE DEPT.
B31
IRS
Prevention Services
F
ARTN"#1F
1501 Truxtun Ave., 1st Floor
IS PIPING GOING TO BE TESTED?
Bakersfield, CA 93301
TANK #
Tel.: (661) 326-3979
CONTENTS,
Fax: (661) 852-2171
Page 1 of 1
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING
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❑ SB-989 SECONDARY CONTAINMENT TESTING
M rnthnrfir Protection Testina
SITE INFORMATION
FACILITY ARCO
NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 1701 Brundage Ln. Bakersfield, Ca.
OWNERS NAME Same
OPERATORS NAME Same
PERMIT TO OPERATE NO.
NUMBER OF TANKS TO BE TESTED
IS PIPING GOING TO BE TESTED?
Q YES Q NO
TANK #
VOLUME
CONTENTS,
1
87 UL
2
87 UL
3
87 UL
4
91 UL
TANK TESTING COMPANY
NAME OF TESTING COMPANY Advanced Compliance
Bruce W. Hinsley 661-706-4321
MAILING ADDRESS 3704 Littlefalls Ct. Bakersfield, Ca. 93312
Bruce W. Hinsley 661-706-4321
CERTIFICATION #: A25212
DATE & TIME TEST TO BE CONDUCTED
icc #: 8032698
SIGNATURE OF APPLICANT
912016
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APPFZOVFD 13Y --e: , — , .. / DATE
FD 2095 (Rev. 09/05)