HomeMy WebLinkAboutApplication SB989 12-17-19_4-5UNDERGROUND 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 S
❑ ENHANCED LEAK LEAK DETECTION !)
❑ TANK TIGHTNESS
❑ LTNETESTING
❑ FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 E Fax: 661-852-2171
Page I of 1
m SB -989 SECONDARY CONTAINMENT
❑ .OVERFILL PREVENTION
SITE INFORMATION
FACILITY
Jaco #77731 Fastrip #31
NAME a PHONE M OF CONTACT PERSON
Ori Garcia (661) 393-7000
ADDRESS
3501 Mt. Vernon Avenue, Bakersfield, CA 93306
OWNER NAME
Jamieson Hill
OPERATOR NAME
Omera Garcia
PERMIT TO OPERATE
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
1
12,000 gal.
87
2
12,000 gal.
91
TANK TESTING COMPANY
TESTING COMPANY
CONFIDENCE UST SERVICES, INC.
NAME i PNON! t OF CONTACT PERSON
Jessica Baker 661631-3870
MAILING ADDRESS
16250 MEACHAM ROAD, BAKERSFIELD, CA 93314.
NAME® PHONE 4 OF TESTER OR SFECDL INSPECTOR
Tim Capehart (661) 5736962
CERTIFICATIONP
TEST METHOD
_
ICC Y
M14476
APP ANT SIGNAT R
L�
DATE
11/20/2019
THIS. PPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/18)