HomeMy WebLinkAbout6601 MING AVE UST FMC APPLICATION 2015APPLICATION
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 # --^
5'
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
117
s
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 - 326 -3979 ® Fax: 661- 852 -2171
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❑ LINE TESTING SB -989 SECONDARY CONTAINMENT
® FUEL MONITORING CERTIFICATION
SITE INFORMATION
FACILITY
NAME & PHONE # OF CONTACT PERSON
Tim Sullivan 661 327 -5008
ADDRESS
6601 Ming Avenue Bakersfield CA 93309
OWNER NAME
Sullivan Petroleum Company
OPERATOR NAME
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
TANK TESTING COMPANY
TESTING COMPANY
Confidence UST Services Inc.
NAME & PHONE # OF CONTACT PERSON
Mel Bolton 661 631 -3870
MAILING ADDRESS
16250 Meacham Road Bakersfield CA 93314
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
CERTIFICATION #
DATE & TIME T ST TO BE CONDUCTED
ICC #
TEST METHOD
APP ANT IG T E
DATE
THIS APPLICATION BECOMES A PER IT WHEN APPROVED
APPROVED BY
DATE f
FD2095 (Rev 03/08)