HomeMy WebLinkAboutLine Test Permit App 7-21-16UNDERGROUND STORAGE TANKS
APPLICATION
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 #
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❑ ENHANCED LEAK DETECTION -1 LINE TESTING (Tank #5) El
❑ TANK TIGHTNESS FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661- 326 -3979 ® Fax: 661- 852 -2171
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❑ SB -989 SECONDARY CONTAINMENT
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 Com an
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
Bryan.Self (661) 487-9355
CERTIFICATION #
B40738 TMI -146 11 -1756
DATE & TIME TEST TO BE CONDUCTED
9:ODara
ICC #
8022804 -UT J
TEST METHOD
TEI LT -3
APPLICANT SIGNATURE
DATE
THIS APPLICATION BECOMES A PERMIT 4JHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/08)