HomeMy WebLinkAbout2301 H ST FMC APP 11.5.14UNDERGROUND 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 #
, al X30
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
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
Sparkling Image Car Wash
NAPE & PHONE # OF CONTACT PERSON
Carl Fisher (661) 324 -8455
ADDRESS
2301 H St Bakersfield CA 93301
OWNER NAME
Wash De of Holdings, Inc.
OPERATOR NAME
Carl Fisher
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
Karli Karns (661) 631 -3870
MAILING ADDRESS
16250 Meacham Road Bakersfield CA 93314
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
KristolDher Karns (661) 340-8602
CERTIFICATION #
B34106
DATE & TIME TEST TO BE CONDUCTED
11 19 14 at :00am
ICC #
5264406 -UT
TEST METHOD
APPLICANT SIG ATURE
DATE
B 1
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/08)