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HomeMy WebLinkAboutUST APPLICATION 9/25/2015UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD I LINE TESTING / SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. I 1,15--Z�= //. ❑ ENHANCED LEAK DETECTION ❑ TANK TIGHTNESS TEST LINE TESTING B B R S F I D AWN A N TNAflr B"ERSFIELD FIRE DEPT. Prevention Services 1501 Truxtun Ave., 1st Floor Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 Page 1 of 1 ❑ SB -989 SECONDARY CONTAINMENT TESTING X TO PERFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Protection Testing SITE INFORMATION FACILITY ARCO NAME & PHONE NUMBER OF CONTACT PERSON ADDRESS 2051 Taft Hwy. 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 2 87 UL 3 91 UL TANK TESTING COMPANY 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 10/21/2014 @ 09:00 ICC #: 8032698 SIGNATURE OF APPLICANT DATE 9/29/2015 APPROVED BY + DATE FD 2095 (Rev. 09/05)