HomeMy WebLinkAboutApplication 6-22-2020UNDERGROUND 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 # I
❑ ENHANCED LEAK DETECTION
❑ LINETESTING
VI FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 P Fax: 661-852-2171
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❑ SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
F03095 (Rev 03/18)
SITE WFORMATION
NAME R PHONE I) CONTACT PERSON
FACILILY
Omero Garcia (661) 393-7000
#3346 Faship #621
ADDRESS
805 34th Street, Bakersfield, CA 93301
OWNER NAME
Jam Hill
OPERATOR NAME
PERMIT TO OPERATE Y
Oinero Garcia (661) 393-7000
# OF TANKS TO BE TESTED:
IS P[PING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
1
12,000 gal.
87 UNL 1
2
12,000 gal.
87 UNL 2
3
12,000 gal.
91 UNL
TANK TESTING COMPANY
XAME S PHONE # OF CONTACT PERSON
TESTING COMPANY
CONFIDENCE UST SERVICES, INC.
Karii Karns (661) 631-3870
MAILING ADDRESS
16250 MEACHAM ROAD, BAKERSFIELD, CA 93314
NAME 6 PHONE R OF TESTER OR SPECIAL INSPECTOR
CERTIFICATION #
Aaron Perrigo (661) 304-2913
TEST METHOD
ICC #
8486827
DATE
APPLICANT SIGNATURE
06101/2020
/
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
F03095 (Rev 03/18)