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HomeMy WebLinkAboutUST-APPL 4/8/2015UNDERGROUND STORAGE TANKS B B R S P I D FIRS ARTN" r APPLICATION TO PERFORM ELD / LINE TESTING / SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO.-- ��� . BAKERSFIELD FIRE DEPT. Prevention Services 1501 Truxtun Ave., 1St Floor Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 Page 1 of 1 ❑ ENHANCED LEAK DETECTION ❑ LINE TESTING X SB -989 SECONDARY CONTAINMENT TESTING ❑ TANK TIGHTNESS TEST TO PERFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Protection Testing SITE INFORMATION FACILITY Lucky 7 #3 NAME & PHONE NUMBER OF CONTACT PERSON ADDRESS 726 S. Union Ave. Bakersfield, Ca. OWNERS NAME Same OPERATORS NAME Sane 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 91 UL 3 Diesel 4 Diesel 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 4/17/2015 @ 09:00 ICC #: 8032698 SIGNATURE OF APPLICANT'" "` DATE 418/2015 APPROVED BY DATE 4111 FD 2095 (Rev. 09/05)