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HomeMy WebLinkAbout2700 OSWELL FMC APP 6.15.15UNDERGROUND 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 # . ❑ ENHANCED LEAK DETECTION ❑ TANK TIGHTNESS x 1 BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661- 326 -3979 • Fax: 661- 852 -2171 Page 1 of 1 ❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT 0 FUEL MONITORING CERTIFICATION FD2095 (Rev 03/08) SITE INFORMATION FACILITY NAME & PHONE # OF CONTACT PERSON ADDRESS 2700 Oswell Street Bakersfield CA 93306 OWNER NAME 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 Brad seykcra (661) 487-92155 CERTIFICATION # B43626 DATE & TIME T ST TO BE CONDUCTED ICC # TEST METHOD A PLIC NT ICyfVA E DATE , THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY .52 DATE FD2095 (Rev 03/08)