HomeMy WebLinkAbout989_2-3 6-16-2020UNDERGROUND 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# D
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
❑ UNETESTING
❑ FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 P Fax: 661-852-2171
Page 1 of 1
m SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
SITE INFORMATION.
FACILITY
Jaco #9933/ Fastrip
NAME S PHONE Y Or CONTACT PERSON
Omem Garcia 661J93-7000
ADDRESS
4800 Fairfax Road, Bakersfield, CA
OWNER NAME
Jaco Hill
OPERATOR NAME
PERMIT TO OPERATE $
# OF TANKS TO BE TESTED:
IS. PIPING GOING TO BE TESTED? D YES ❑ NO
TANK #
VOLUME
CONTENTS
1
12,000 gal
87
2
12,000 gal
91
3
12,000 gal
DSL
TANK TESTING COMPANY
TESTING COMPANY
CONFIDENCE UST SERVICES, INC.
NAME A PHONE R OF CONTACT PERSON
Jessica Baker 661-631-3780
MAILING ADDRESS
16250 MEACHAM ROAD, BAKERSFIELD, CA 93314
NAME a PHONE 4 OF TESTER OR SPECIAL INSPECTOR
Justin Williams
CERTIFICATION #
TEST METHOD
ECC
8819073
APPLICANT SIGNATURE
%
t/
DATE
06/05/2020
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
F02095 (Rev 03/18)