HomeMy WebLinkAbout989 Permit App 8-15-16APPLICATION
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 #,� f
❑ ENHANCED LEAK DETECTION
n TONIC TT(.HTNF -,r,
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BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661- 326 -3979 ® Fax: 661 - 852 -2171
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❑ LINE TESTING (Z SB -989 SECONDARY CONTAINMENT
❑ FUEL MONITORING CERTIFICATION
SITE INFORMATION
FACILITY
Jaco 3366 Fastri 640 ]0mero
NAME & PHONE # OF CONTACT PERSON
Garcia (661) 393 -7000
ADDRESS
8001 White Lane Bakersfield CA 93309
OWNER NAME
Jaco Hill
OPERATOR NAME
Omero Garcia
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 (661)303 -8550
CERTIFICATION #
DATE & TIME TEST TO BE CONDUCTED
8/15/16.at 9:00am
ICC #
-11T
TEST METHOD
APPLICANT SIG URE
DATE ,
THIS APPLICATION BECOMES A PERMIT i1HEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/08)