HomeMy WebLinkAboutUST-APPL 5/4/2015UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD / LINE TESTING
/ SB989 SECONDARY CONTAINMENT TESTING
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO. 1I)0a - %L'
BAKERSFIELD FIRE DEPT.
Prevention Services
1501 Truxtun Ave., 1St Floor
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
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❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT TESTING
n TANK T1rHTNFSS TFRT X TO PERFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Protection Testinq
SITE INFORMATION
FACILITY Sam Sambee Enterprises Inc.
NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 2301 F. 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
2
87 UL
3
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
DATE 5/4/2015
APPROVED BY ' DATE --
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