HomeMy WebLinkAboutUST-APPL 10/28/2014UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD / LINE TESTING
/ SB989 SECONDARY CONTAINMENT TESTING
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO.
B F$ R 3 p I D
T
BAKERSFIELD FIRE DEPT.
Prevention Services
900 Truxtun Ave., Ste. 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
Page 1 of 1
,e5 ENHANCED LEAK DETECTION X LINE TESTING eS SB -989 SECONDARY CONTAINMENT TESTING
zS TANK TIGHTNESS TEST X TO PERFORM FUEL MONITORING CERTIFICATION
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SITE INFORMATION
FACILITY
Pacific Bell Telephone Co.
dba AT &T California
NAME & PHONE NUMBER OF CONTACT PERSON
Grant Armstrong (661) 327 -6903
ADDRESS
1918 M Street
OWNERS NAME
Pacific Bell Telephone Co. dba AT &T California
OPERATORS NAME
AT &T
PERMIT TO OPERATE NO.
NUMBER OF TANKS TO BE TESTED
IS PIPING GOING TO BE TESTED? Xe YES es NO
TANK #
VOLUME
CONTENTS
SA004UO01
20,000 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
Pat Banbury
CERTIFICATION #:
Banbury- 5254955 -UT
DATE & TIME TEST TO BE CONDUCTED
12/2/2014 @ 9:00am
[CC #: 8613043701
TEST METHOD
SIGNATURE OF APPLICANT
DATE 10/28/2014
TKtS APPLIMION RECONES, A. PERNE WHEN PE : APPROVED
APPROVED BY 4
DATE
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UNDERGROUND STORAGE TANKS
APPLICATION
PERMIT NO.
B E A F I :D
*AFR1RT'ffffAfJT
BAKERSFIELD FIRE DEPT.
Prevention Services
900 Truxtun Ave., Ste. 210
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
Page 1 of 1
)F5 ENHANCED LEAK DETECTION LINE TESTING e SB -989 SECONDARY CONTAINMENT TESTING
.!S TANK TIGHTNESS TEST X TO PERFORM FUEL MONITORING CERTIFICATION
FD 2095 (Rev. 09/05)
SITE INFORMATION
FACILITY
Pacific Bell Telephone Co.
dba AT &T California
NAME & PHONE NUMBER OF CONTACT PERSON
Grant Armstron (661) 327 -6903
ADDRESS
1918 M Street
OWNERS NAME
Pacific Bell Telephone Co. dba AT &T California
OPERATORS NAME
AT &T
PERMIT TO OPERATE NO.
NUMBER OF TANKS TO BE TESTED
IS PIPING GOING TO BE TESTED? Xs YES ,K NO
TANK #
VOLUME
CONTENTS
SA004UO01
20,000 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
Pat Banbury
CERTIFICATION #:
Banbury - 5254955 -UT
DATE & TIME TEST TO BE CONDUCTED
12/2/2014 @ 9.00am
ICC #: 8613043701
TEST METHOD
SIGNATURE OF APPLICANT
DATE 10/28/2014
THM APPLICATION
BECONE <APERMW BECOME WHEN APPROVED
APPROVED BY /L
DATE / z e l t
FD 2095 (Rev. 09/05)