HomeMy WebLinkAboutFMC-989 Permit App. 8-31-16_1-4APPLICATION
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 #
$ AkE R S F lik D
FIRE
ARrte► r
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661- 326 -3979 o Fax: 661 - 852 -2171
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❑ ENHANCED LEAK DETECTION ❑ LINE TESTING R SB -989 SECONDARY CONTAINMENT
❑ TANK TIGHTNESS ® FUEL MONITORING CERTIFICATION
SITE INFORMATION
FACILITY
Kern County General Services Yard
NAME & PHONE # OF CONTACT PERSON
Tim Haub 661 - 868 -3880
ADDRESS
1415 Truxtun Avenue, Bakersfield, CA 93301
OWNER NAME
-F. OPERATOR NAME
Brad Aragon 661 - 868 -3880
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
Cameron Mason
CERTIFICATION #
842599
DATE & TIME TEST TO BE CONDUCTED
08/31/2016 9:00 am
ICC #
8174721 -UT
TEST METHOD
APPLICANT SA NATURE RE
DATE
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 12/15)