HomeMy WebLinkAboutApp 2018UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD I LINE TESTING
SB989 SECONDARY CONTAINMENT TESTING
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
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FACILITY SAMCO
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BAKERSFIELD FIRE DEPT.
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Prevention Services
PERMIT TO OPERATE NO.
IRS
F
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
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1501 Truxtun Ave., 1-A Floor
CONTENTS
Bakersfield, CA 93301
Tel.: (661) 326-3979
2
Fax: (661) 852-2171
91 UL
Page 1 of 1
PERMIT NO. I
ENHANCED LEAK DETECTION ❑ LINE TESTING X SB-989 SECONDARY CONTAINMENT TESTING
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SITE INFORMATION
FACILITY SAMCO
NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 3300 White Lane 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
1. TANK #
VOLUME
CONTENTS
87 UL
2
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
0/2018
Mr penw, vow
APPROVED BY DATE
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