HomeMy WebLinkAboutSB989 APP 4.24.19UNDERGROUND 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 I
❑ ENHANCED LEAK DETECTION 1:1 LINE
❑ TANK TIGHTNESS 171 FUEL
BAKERSFI
Preventim
2101 H Strei
Bakersfield,
Phone: 661-'-:
Page I of 1
D F;ARE DEPARTMENT
ervilbes
93391
.3970 ® Fax: 661-852-2171
0 SB-989 SE 6NDAR CONTAINMENT
❑ 0 �, EVENT ON
FD2095 (Rev 03/18)
ITE INFO
I ;tMATION
FACILITY
Jaco #3360/ Farrell's Fastrip
NAME & F!'HONE,
Dmero Gc-kcia
# 0 -1i93
6 ; 61
C -7000 0NTACT PERS
t
ADDRESS
6401 White Lane, Bakersfield, CA 93309
OWNER NAME
Jaco Hill
OPERATOR NAME
PERMIT T6
OPERAT E
# OF TANKS TO BE TESTED:
IS PIPING
GOING TO
BE TESL
E
❑ NO
TANK #
VOLUME
�ONT
INTS
1
2,000
6al
7
2
2,000
Gal
3
�
2 000
al
DED
L
TANK
TESTING
COMP
�y
TESTING COMPANY
CONFIDENCE UST SERVICES, INC.
NAME &
Jessica Bo
ONE # OF
�IH er 661-
k
CONTACT PERSON1
31 -3780
1
MAILING ADDRESS
16250 MEACHAM ROAD, BAKERSFIELD, CA 93314
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Austin Sterling 661-703-0857
CERTIFI
1345438�
ON #
TEST METHOD
ICC #
8339953
APPLICA fSIGN TUXRE
DATE
3/1/201
THIS APPLICATION BECOMES
A PERMIT
WHEN
APPR6�ED
APPROVED BY
DATE
FD2095 (Rev 03/18)