HomeMy WebLinkAboutFMC RE-Test Application 5-26-16UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD / LINE TESTING
/ SB989 SECONDARY CONTAINMENT TESTING
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO. /6-1 30' j
s ERSPI !Po'OrD
FIRS
A R mifir
BAKERSFIELD FIRE DEPT.
Prevention Services
1501 Truxtun Ave., 1St Floor
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
Page 1 of 1
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT TESTING
Ci TANK TIrHTNFSS TFRT N TO PERFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Protection Testina
FD 2095 (Rev. 09 /U5)
SITE INFORMATION
FACILITY ARCO
NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 6450 White Lane Bakersfield, Ca.
OWNERS NAME Same
OPERATORS NAME Same
PERMIT TO OPERATE NO.
NUMBER OF TANKS TO BE TESTED
IS PIPING GOING TO BE TESTED? 0 YES
0 NO
TANK #
VOLUME
CONTENTS
1
87 UL
2
87 UL
3
Retest 91 UL Line
91 UL
Leak Detector
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 - 4,.-
DATE 5/19/2016
4k 04 #01"Now-4
APPROVED BY :...
DATE
FD 2095 (Rev. 09 /U5)