HomeMy WebLinkAboutUST-APPL. 3/12/2015UNDERGROUND STORAGE TANKS
3 B R 3 F i D
ARfI� f
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 ❑ SB -989 SECONDARY CONTAINMENT TESTING
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SITE INFORMATION
FACILITY Circle Deli
NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 1416 Golden State 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
1
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 6611 -706 -4321
CERTIFICATION #:A25212
DATE & TIME TEST TO BE CONDUCTED
iCC #: 8032698
SIGNATURE OF APPLICANT ~�G✓
DATE 3112/2015
APPROVED BY ,° DATE / �
ru zuuo kmev. uwvo)
UNDERGROUND STORAGE TANKS
TO PERFORM ELD / LINE TESTING
/ SB989 SECONDARY CONTAINMENT TESTING
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO.�(
At TNA41r
BAKERSFIELD FIRE DEPT.
Prevention Services
1501 Tr uxtun Ave., l st Floor
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
Page 1 of 1
11 ENHANCED LEAK DETECTION X LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT TESTING
171 TANK Tlr.147rNFSS TEST TO PERFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Protection Testina
C" SITE INFORMATION
FACILITY Circle Drr-eIt
NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 1416 Golden State 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
1
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
ICC #: 8032698
SIGNATURE OF APPLICANT rte,
DATE 3/1212015
Blip r WIWWMIMV W014-1
APPROVED BY r a DATE
i
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