HomeMy WebLinkAbout2016 FMC PERMIT APPLICATIONAPPLICATION
TO PERFORM ELD /LINE TESTING/
SB989 SECONDARY CONTAINMENT
TESTING /TANK TIGHTNESS TEST AND
FUEL MONITORING CERTIFICATION
(Please note that these are separate
individual tests and will be Charged per
separate type test accordingly.)
PERMIT #
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
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ILI
BAKESFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 -326 -3979 ® Fax: 661 -852 -2171
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❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT
FUEL MONITORING CERTIFICATION
SITE INFORMATION
FACILITY
Wholesale Fuels, Inc.
NAME & PHONE # OF CONTACT PERSON
O Garcia (661) 393 -7000
ADDRESS
2200 East Brundage Ln., Bakersfield, CA 93307
OWNER NAME
Jaco Oil Company
OPERATOR NAME
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
TANK TESTING COMPANY
TESTING COMPANY
Confidence UST Services Inc.
NAME & PHONE # OF CONTACT PERSON
Mel Bolton (661) 631 -3870
MAILING ADDRESS
16250 Meacham Road Bakersfield CA 93314
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Self (661) 487-93-55
CERTIFICATION #
B40738
-Bryan
DATE & TIME TEST TO BE CONDUCTED
ICC #
8022804 -UT
TEST METHOD
APPLIC T SI NA R
DA E F
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
bdtl
FD2095(Rev 03/08)