HomeMy WebLinkAboutApp 250 Coffee 121918UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD / LINE TESTING
I SB989 SECONDARY CONTAINMENT TESTING
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO. I I
0 ENHANCED LEAK DETECTION ❑ LINE TESTING
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5,01M
BAKERSFIELD FIRE DEPT.
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B E R S ? I D
Prevention Services
1501 Truxtun Ave., 16t Floor
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
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❑ SB-989 SECONDARY CONTAINMENT TESTING
L-J TANK TIGHT I NL55 I EST AA. I tt:KI-VKM t-UtL MUM IUKINU UI=Kl IrIUAI IVN L-i %-0dL1IVUIL;r1VLWUE1V1I
FACILITY Sully's Stockdale NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 250 Coffee 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
1 87 UL
2 91 UL
3 Diesel
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 12/512018
APPROVED BY
DATE
FU ZU95 (Kev. uwuo)