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HomeMy WebLinkAboutFMC APP 12.5.19UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD !LINE TESTING I SB989 SECONDARY CONTAINMENT TESTING (TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. ❑ ENHANCED LEAK DETECTION ❑ LINE TESTING CI TANK TICHTNFSfi TFST XTO PERFORM FUEI ❑ Cathode Protection Testing SITE INFORMATION BAKERSFIELD FIRE DEPT. ° MRTN Prevention Services OWNERS NAME Same OPERATORS NAME Same PERMIT TO OPERATE NO. 2101 H Street IS-PIPING GOING TO BE TESTED'! ❑ YES Bakersfield, CA 93301 TANK # Tel.: (661) 326 -3979 _ Fax: (661) 852 -2171 1 Page i of 1 38-989 SECONDARY CONTAINMENT TESTING ❑ Cathode Protection Testing V LVFe IRCV. Vtln/a) SITE INFORMATION FACILITY Sam's Liquor and Gas I NAME 8 PHONE NUMBER OF CONTACT PERSON _ ADDRESS 801 E California Bakersfield, Ca. OWNERS NAME Same OPERATORS NAME Same PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS-PIPING GOING TO BE TESTED'! ❑ YES ❑ NO TANK # VOLUME _ CONTENTS 1 87 UL 2 91 UL 3 Diesel TANK TESTING COMPANY NAME OF TESTING COMPANY Advanced Compliance Bruce W. Hinsley 661 - 706-4321 MAILING ADDRESS 3704 Littlefalls Ct. Bakersfield, Ca. 93312', Bruce W. Hinsley 661 - 706 -4321 CERTIFICATION #, A25212 DATE 8 TIME TEST TO BE CONDUCTED ec #- 6032698 SIGNATURE OF APPLICANT w �� DATE 11/27/2019 11111111111 1111111114,11111:1§,11 1 OAT, APPROVEDBY V LVFe IRCV. Vtln/a)