HomeMy WebLinkAboutnorth_Application 7-23-19UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD/LINE TESTING/
SB989 SECONDARY CONTAINMENT
TESTING/TANK TIGHTNESS TEST AND
FUEL MONITORING CERTIFICATION
(Please note that these are Separate
individual tests and will be charged per
separate type test accordingly.)
PERMIT # I '
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING
❑ TANK TIGHTNESS Ia FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 o Fax: 661-852-2171
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❑ SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
SITE INFORMATION
FACILITY
Jaco #7721/ Fastrip #22
NAME & PHONE # OF CONTACT PERSON
Omero Garcia 661-393-7000
ADDRESS
4013 South H Street, Bakersfield, Ca 93304
OWNER NAME
Jamieson Hill
OPERATOR NAME
Omero Garcia
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
1
12,000 gal.
87 UNL
2
12,000 gal.
91 UNL
TANK TESTING COMPANY
TESTING COMPANY
CONFIDENCE UST SERVICES, INC.
NAME & PHONE # OF CONTACT PERSON
Jessica Baker 661-631-3870
MAILING ADDRESS
16250 MEACHAM ROAD, BAKERSFIELD, CA 93314
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Tim Capehart (661) 573-8962
CERTIFICATION #
TEST METHOD
ICC #
8414476
APPLI T SIGN UR
a
DATE
6/11/2019
THIS APPLICATION BECOMES A PERMIT .WHEN APPROVED
APPROVED BY
DATE
FD2095(Rev 03/18)