HomeMy WebLinkAboutSB989 APP 12.10.19UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD / LINE TESTING
/ SB989 SECONDARY CONTAINMENT TESTING
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO. D
❑ ENHANCEDLEAKDETECTION ❑LINE TESTING
❑ TANKTIGHTNESSTEST __ TO PERFORM FUEL
BAKERSFIELD FIRE DEPT.
���� ° Prevention Services
AIfI 2101 H Street
A Bakersfield, CA 93301
Tel.: (661( 326 -3979
Fax: (66 1) 852-2171
Page I of I
X S &BBB SECONDARY CONTAINMENT TESTING
❑ CathodicProtection Testing
FD 2095 (Rev. 09105)
SITE INFORMATION
FACILITY Sam's Liquor and Gas NAME S 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
O NO
TANK t1
VOLUME
CONTENT
1
87 UL
2
91 UL
3
Diesel
TANK TESTING COMPANY
NAME OF TESTING COMPANY Advanced Compliance
Bruce W. Hinsley 661- 7064321
MAILING ADDRESS 3704 Littlefalls CL Bakersfield, Ca. 93312
Bruce W. Hinsley 661- 7084321
CERTIFICATION#: A25212
DATE a TIME TEST TO BE CONDUCTED
Icc A: 8032698
SIGNATURE OF APPLICANT. G.-
DATE 1112712018
APPROVED BY
GATE
FD 2095 (Rev. 09105)