HomeMy WebLinkAboutUST-APPL. 5/12/2015UNDERGROUND STORAGE TANKS
PERMIT #
15--
❑ ENHANCED LEAK DETECTION
A.
F I
FIRN
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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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❑ LINE TESTING R SB-989 SECONDARY CONTAINMENT
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SITE INFORMATION
NAME & PHONE # OF CONTACT PERSON
FACILITY
Manager (661) 549-1711
7/11# 16329
ADDRESS
1701 Pacheco Road, Bakersfield, CA 93307
OWNER NAME
Southland
OPERATOR NAME
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? YES ❑ NO
VOLUME
CONTENTS
TANK #
T1
10K
Regular
T2
10K
Regular
T3
10K
Premium
TANK TESTING COMPANY
NAME & PHONE OF CONTACT PERSON
TESTING COMPANY
I Michelle Cleghorn-Young, 951-676-4060
Tanknology
MAILING ADDRESS CA 92590
41785 Enterprise Circle South Suite# D, Temecula ,
CERTIFICATION #
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR ICC Service Technician
Jeffrey Crisostomo, 619-903-5390
TEST METHOD
TEST METHOD
ACC #
DATE & TIME TEST TO BE CONDUCTED 8199847-UT
DATE
APPLICA 'SIGNAT'URE
IS LIGATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FDZU95 (KeV U-5/UO)