HomeMy WebLinkAboutFMC APP 2.20.19UNDERGROUND STORAGE TANKS
APPLICATION
BAKERSFIELD FIRE DEPT.
TO PERFORM ELD I LINE TESTING
Prevention Services
SB989 SECONDARY CONTAINMENT TESTING
MPA R TMAIT
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO.
1 1
Fax: (661) 852-2171
Page 1 of I
❑ ENHANCED LEAK DETECTION LINE TESTING
❑ SB-989 SECONDARY CONTAINMENT TESTING
U TANK TIGHTNESS TEST A TO PERFORM FUEL MONITORING CERTIFICATION LJ Gatnoclic Protection I esting
SIT
IN ORMATI N.,,,-
FACILITY Sullivans
NAME & PHONE NUMBER OF CONTACT PERSON
I
ADDRESS 11400 Ming 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
1 20,000 87 UL
2 12,000 91 UL
3 10,000 Diesel
NAME OF TESTING COMPANY Advanced Compliance I Bruce W. Hinsley 661-706-4321
MAILING ADDRESS 3704 Littlefalls Ct. Bakersfield, Ca. 93312
Brad W. Hinsley 661-706-4321 CERTIFICATION #:B46141
DATE & TIME TEST TO BE CONDUCTED icc #: 8373948
iSIGNATURE OF APPLICANT !� I
, i DATE 121512018
APPROVED BY
DATE
FD 2095 (Rev. 09/05)
BAKERSFIELD FIRE DEPT.
B Bye R S F I D
Prevention Services
A
MPA R TMAIT
1501 Truxtun Ave., 18t Floor
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
Page 1 of I
❑ SB-989 SECONDARY CONTAINMENT TESTING
U TANK TIGHTNESS TEST A TO PERFORM FUEL MONITORING CERTIFICATION LJ Gatnoclic Protection I esting
SIT
IN ORMATI N.,,,-
FACILITY Sullivans
NAME & PHONE NUMBER OF CONTACT PERSON
I
ADDRESS 11400 Ming 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
1 20,000 87 UL
2 12,000 91 UL
3 10,000 Diesel
NAME OF TESTING COMPANY Advanced Compliance I Bruce W. Hinsley 661-706-4321
MAILING ADDRESS 3704 Littlefalls Ct. Bakersfield, Ca. 93312
Brad W. Hinsley 661-706-4321 CERTIFICATION #:B46141
DATE & TIME TEST TO BE CONDUCTED icc #: 8373948
iSIGNATURE OF APPLICANT !� I
, i DATE 121512018
APPROVED BY
DATE
FD 2095 (Rev. 09/05)