HomeMy WebLinkAboutApplication 12-16-19_4-8PERMIT NO.
❑ ENHANCEDLEAKDETECTION ❑ UNETESTING ❑ S&989 SECONDARY CONTAINMENTTESTING
n TANK TIGHTNFSB TEST X TO PERFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Pmte0tiw Testing
SITE INFORMATION,_
UNDERGROUND STORAGE TANKS
BAKERSFIELD FIRE DEPT.
FACILITY Sully's Coffee
Prevention Services
-uxtun Ave., I sl Floor
1,,PPLIC.ATION
field, CA 93301
T,-.',. PERFORM ELD / LINE TESTING
561) 326-3979
1;''989 SECONDARY CONTAINMENT TESTING 561)852-2171
(TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO.
❑ ENHANCEDLEAKDETECTION ❑ UNETESTING ❑ S&989 SECONDARY CONTAINMENTTESTING
n TANK TIGHTNFSB TEST X TO PERFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Pmte0tiw Testing
SITE INFORMATION,_
FACILITY Sully's Coffee
NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 6009 Coffee Rd. Bakersfield, Ca.
OWNERS NAME Same
OPERATORS NAME Same I PERMIT TO OPERATE NO.
NUMBER OF TANKS TO BE TESTED ,ISPIPING GOING To BETESTE01 �_ YES____
�,NO
._.—_ TANK # _ VO�Jt.ME— __._......___IgONTE✓�T4..-----------
1
87 UL
y
91 UL
3
Diesel
TANK TESTING COMPANY
Compliance Bruce W. Hinsley 661-706-4321
NAME OF TESTING COMPANY Advanced
MAILING ADDRESS 3704 Littlefalis Ct. Bakersfield, Ca. 93312—
Bruce W. Hinsley 661-706.4321 CERTIFICATION M: A25212
�I
DATE & TIME TEST TO BE CONDUCTED 1 211 6 /2 01 9 O8: W Icc n: 8032698
SIGNATURE OF APPLICANT I DATE 7/25/2079
j APPROVED BYDATE
FO 2095 (Rev. 09/05)