HomeMy WebLinkAboutFMC APP 1.21.19FACILITY CALIFORNIA MINI MART NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 1129 UNION AVE. 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
NAME OF TESTING COMPANY Advanced Compliance Bruce W. Hinsley 861- 706 -4321
MAILING ADDRESS 3704 Littlefalls Ct, Bakersfield, Ca. 93312
Brad W. Hinsley 661 -706 -4321 CERTIFICATION #:B46141
DATE & TIME TEST TO BE CONDUCTED ICC #: 8373948
SIGNATURE OF APPLICANT _ 9 -7 L _ ° DATE 12/512018
APPROVED BY I DATE
FD 2095 (Rev. 09/05)
UNDERGROUND STORAGE TANKS
BAKERSFIELID FIRE DEPT.
B B B 8 F I
D Prevention Services
'
t
T 2101 H Street
APPLICATION
Bakersfield, CA 93301
TO PERFORM ELD / LINE TESTING
Tel.: (661) 326 -3979
/ SB989 SECONDARY CONTAINMENT TESTING
Fax: (661) 852 -2171
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
Page 1 of 1
PERMIT NO.
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING
❑ S13-989 SECONDARY CONTAINMENT TESTING
❑ TANK TIGHTNESS TEST x TO PERFORM FUEL MONITORING CERTIFICATION
❑ Cathodic Protection Testing
FACILITY CALIFORNIA MINI MART NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 1129 UNION AVE. 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
NAME OF TESTING COMPANY Advanced Compliance Bruce W. Hinsley 861- 706 -4321
MAILING ADDRESS 3704 Littlefalls Ct, Bakersfield, Ca. 93312
Brad W. Hinsley 661 -706 -4321 CERTIFICATION #:B46141
DATE & TIME TEST TO BE CONDUCTED ICC #: 8373948
SIGNATURE OF APPLICANT _ 9 -7 L _ ° DATE 12/512018
APPROVED BY I DATE
FD 2095 (Rev. 09/05)