HomeMy WebLinkAboutLine Test Permit App 11-3-16UNDERGROUND STORAGE TANKS
PERMIT # ) 0 n 02
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B IE R S F It D
F IRE
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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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El LEAK DETECTION E-rESTI G El SB -989 SECONDARY CONTAINMENT
❑ TANK TIGHTNESS 8 FUEL MO iORING CERTIFICATION
TE INFORMATION
FACILITY
Wholesale Fuels, Inc.
NAME & PHONE # OF CONTACT PERSON
Omero Garcia (661) 393 -7000
ADDRESS
2200 East Brundage Lane, Bakersfield, CA 93307
OWNER NAME
Jaco Oil Company
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
i4AME & PHONE # OF CONTACT PERSON
Mel Bolton 661 -631 -3780
MAILING ADDRESS
16250 Meacham Road, Bakersfield, CA 93314
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Bradley Seykora (661) 487 -9355
CERTIFICATION #
B40738
DATE & TIME TEST TO BE CONDUCTED
TBD
ICC #
8111231 -UT
TEST METHOD
APPLICANT SIGNATURE
DATE
10/26/2016
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
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FD2095 (Rev 12/15)