HomeMy WebLinkAboutUST APPL. 11/25/2015UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD / LINE TESTING
/ SB989 SECONDARY CONTAINMENT TESTING
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO. I & —42Q22 1
BAKERSFIELD FIRE DEPT.
Prevention Services
900 Truxtun Ave., Ste. 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
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,EIS ENHANCED LEAK DETECTION A5 LINE TESTING CES SB -989 SECONDARY CONTAINMENT TESTING
,@!5 TANK TIGHTNESS TEST X TO PERFORM FUEL MONITORING CERTIFICATION
FD 2095 (Rev. 09105)
SITE INFORMATION
FACILITY
AT &T Corporation
NAME & PHONE NUMBER OF CONTACT PERSON
Grant Armstrong (661) 327 -6903
ADDRESS
1520 20th Street
OWNERS NAME
AT &T Corporation
OPERATORS NAME
AT &T
PERMIT TO OPERATE NO,
NUMBER OF TANKS TO BE TESTED
IS PIPING GOING TO BE TESTED? YES e NO
TANK #
VOLUME
CONTENTS
CAK01OU001
8,000 Gallons
Diesel
TANK TESTING COMPANY
NAME OF TESTING COMPANY
Tait Environmental
Services, INC.
NAME & PHONE NUMBER OF CONTACT PERSON
Carlos Cardenas (714) 567 -6418
MAILING ADDRESS
2131 South Dupont
Drive, Anaheim CA 92806
NAME & PHONE NUMBER OF TESTER OR SPECIAL INSPECTOR
Adolfo Aguilar
CERTIFICATION #:
1732573702
DATE & TIME TEST TO BE CONDUCTED
12/17_Z2014 @ 9:00am
ICC #:
5238610
TEST METHOD
SIGNATURE OF APPLICANT
DATE 11/25/2014
THtS APP : CATI:ON. BECOMES; A. P - RMrF WHEN APPROVED
APPROVED BY It
' DATE
FD 2095 (Rev. 09105)