HomeMy WebLinkAboutApplication SB989 2-11-21UNDERGROUND 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 TIGHTNESS
❑ LINE TESTING
❑ FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 • Fax: 661-852-2171
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0 SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
SITE INFORMATION
FACILITY
Jaco #3362/ Fastrip #633
NAME & PHONE # OF CONTACT PERSON
Omero Garcia 661-393-7000
ADDRESS
6401 South H Street, Bakersfield, CA 93304
OWNER NAME
Jamieson Hill
OPERATOR NAME
Omero Garcia
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
1
12,000 gal.
87 UNL
2
12,000 gal.
91 UNL
3
12,000 gal.
DSL
TANK TESTING COMPANY
TESTING COMPANY
CONFIDENCE UST SERVICES, INC.
NAME & PHONE # OF CONTACT PERSON
Karli Karns661-631-3870
MAILING ADDRESS
16250 MEACHAM ROAD, BAKERSFIELD, CA 93314
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Justin Williams 661-859-9966
CERTIFICATION #
EST METHOD
A
ICC #
8819073
A PLICANT SIGNATURE
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DATE
12/29/2020
R
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/18)