HomeMy WebLinkAboutUST-APPL. 9/16/2016UNDERGROUND STORAGE TANKS
BAKERSFIELD FIRE DEPT.
B34E x 8 F I D Prevention Services
A R
FIRS
0 TNAffir 2101 H Street
&
APPLICATION a Bakersfield, CA 93301
TO PERFORM ELD / LINE TESTING Tel.: (661) 326-3979
SB989 SECONDARY CONTAINMENT TESTING Fax: (661) 852-2171
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION Page 1 of 1
PERMIT NO. 1 lj�,7 - / OOE)o S--61 I
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ SB-989 SECONDARY CONTAINMENT TESTING
❑ TANK TIGHTNESS TEST X TO PERFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Protection Testing
FACILITY Jim Burke Ford NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 2001 Oak St. Bakersfield, Ca.
OWNERS NAME Same
OPERATORS NAME Same PERMIT TO OPERATE NO.
NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK # VOLUME CONTENTS
1 87 UL
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 ,
jr� ! DATE 9/16/2016
I APPROVED BY
I
DATE 4
in gnq-;; tPAv nq/n!;i