HomeMy WebLinkAboutApplication 6-26-20_4-7UNDERGROUND 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#
❑ ENHANCED LEAK DETECTION
❑ TANK
❑ LINE TESTING
m FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 + Fax: 661-852-2171
Page 1 of I
❑ 5B-989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
FD2095 (Rev 03118)
SITE INFORMATION
FACILRY
NAME & PHONE # OF
CONTACT PERSON
Kern County General Yard
Omero Garcia, 661-428-5457
ADDRESS
705 S Union Ave., Bakersfield, CA 93301
-
OWNERNAME
OPERATOR NAME
PERMIT TO OPERATE
A
Omero Garcia, 661428-5457
# OF TANKS TO BE TESTED:
IS. PIPING GOING TO BE TESTED?
❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
1
12,000 gal.
—r
87-1
2
12,000 gal.
91
TANK TESTING COMPANY
TESTING COMPANY
NAME & PHONE # Of CONTACT PERSON
CONFIDENCE UST SERVICES, INC.
-
MAILING ADDRESS
16250 MEACHAM ROAD, BAKERSFIELD, CA 93314
.
NAME & PHONE # 9F TESTER OR SPECIAL INSPECTOR
CERTIFICATION #
Aaron PerngD (661) 304-2913
ICC
TEST METHOD
lcc a
8485827 -UT
APPLICANT SIGNATURE
DATE
05/29)20
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03118)