HomeMy WebLinkAboutSB989 APP 9.27.19UNDERGROUND 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 #
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
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wOMLPRV
❑ LINETESTING
❑ FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfeld, CA 93301
Phone: 661- 326 -3979 E Fax: 661 -852 -2171
Page 1 of 1
0 SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
SITE INFORMATION
FACILITY
Jaw #2233/ D 8 G Liquors
NAME A PHONE t OF CONTACT PERSON
Omem Garda (661) 393 -7000
ADDRESS
2732 Brundage Lane, Bakersfield, CA 93304
OWNER NAME
Jaw Hill
OPERATOR NAME
PERMIT TO OPERATE R
k OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK O
VOLUME
CONTENTS
1
12,000 gal.
87
2
12,000 gal.
91
3
12,000 gal.
DSL
TANK TESTING COMPANY
TESTING COMPANY
CONFIDENCE UST SERVICES, INC.
NAME A PHONE Y OE CONTACT PERSON
Jessica Baker 661 -631 -3870
MAILING ADDRESS
16250 MEACHAM ROAD, BAKERSFIELD. CA 93314
NAME a PHONE A OF TESTER OR SPECIAL INSPECTOR
Tim Capehad (661) 573 -8962
CERTIFICATIONR
TEST METHOD
Icc A
8414476
APPL SIGNAT RE
DATE
6/12/2019
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/18)