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HomeMy WebLinkAboutUST-APPL 7/14/2013UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD / LINE TESTING / SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. L - ., ENHANCED LEAK DETECTION ❑ TANK TIGHTNESS TEST LINE TESTING B B R s P I or kwArll< AifTN.' f 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 ❑ SB -989 SECONDARY CONTAINMENT TESTING X TO PERFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Protection Testinq SITE INFORMATION FACILITY Jim Burke Ford NAME & PHONE NUMBER OF CONTACT PERSON ADDRESS 2001 Oak St. 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 TANK TESTING COMPANY NAME OF TESTING COMPANY Advanced Compliance Bruce W. Tinsley 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 I= #: 8032698 SIGNATURE OF APPLICANT 1 ,k DATE 7114/2013 Ole APPROVED BY ° DATE { I-L) 1U9b (Kev. uvwt))