HomeMy WebLinkAboutUST-APPL 4/23/2014UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD / LINE TESTING
/ SB989 SECONDARY CONTAINMENT TESTING
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO. I .,.._._,.._,.....__.... —I
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BAKERSFIELD FIRE DEPT.
Prevention Services
1501 Truxtun Ave., Ist 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
M TANK TIrrHTNF .qS TFRT X TO PFRFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Protection Testina
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SITE INFORMATION
FACILITY Real Wilson Ent.
NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 3699 Wilson Rd. 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 4123/2014
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APPROVED BY r
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