HomeMy WebLinkAboutApp 2018 Sullys NorthIle �
S
UNDERGROUND STORAGE TANK
APPLICATION
TO PERFORM ELD / LINE TESTING
I SB989 SECONDARY CONTAINMENT TESTING
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO. I I
U lik
B"ERSFIELD FIRE DEPT.
Prevention Services
1501 Truxtun Ave., 18t Floor
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
Page I of 1
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING El SB-989 SECONDARY CONTAINMENT TESTING
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SITE INFORMATION
FACILITY Sully's Downtown Chevron North
NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 2317 L 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
4
Diesel
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 -AM-
icc #: 8032698
SIGNATURE OF APPLI ANT
DATE 11/0912018
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n AM 01 1 - I
A PERM VOW, 1 AP IMMUM,
APPROVED BY
DATE
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