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HomeMy WebLinkAboutFMC Application 4-1-21PERMIT NO. ❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT TESTING ❑ TANK TIGHTNESS TEST X TO PERFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Protection Testing _. irk .-- t l.:.. -. f"1.. A -T-1 /1 ...V\/7(l, \. ■:'. .v.■s. FACILITY OLIVE REFRESH NAME & PHONE NUMBER OF CONTACT PERSON -- UNDERGROUND STORAGE TANKS ,��-n,a _ ' S F IPrevention BAKE RSFTELD FIS" DEPT, Services _,...,... _... w ......,..._.. , _._....._ _ FIRS dun Ave., lst Floor 11PPLICATIOn :field, CA 93301 Ti ' PERFORIN ELD 1 LINE TESTING 561) 326-3979 / .^.;,'.8989 SECONDARY CONTAINMENT TESTING 361) 852-2171 /TANK TIGHTNESS TEST AND TO PERFORIN FUEL MONITORING CERTIFICATION TANK # PERMIT NO. ❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT TESTING ❑ TANK TIGHTNESS TEST X TO PERFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Protection Testing _. irk .-- t l.:.. -. f"1.. A -T-1 /1 ...V\/7(l, \. ■:'. .v.■s. FACILITY OLIVE REFRESH NAME & PHONE NUMBER OF CONTACT PERSON -- ADDRESS 11212 Olive Dr, Bakersfield 93312 OWNERS NAME Same PERMIT TO OPERATE NO, OPERATORS NAME Sarre NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO TANK # VOLUME CONTENTS 1 87 2 91 3 Diesel e f @t E TANK TESTING COMPANY NAME OF TESTING COMPANY Advanced Compliance Bruce W. Hinsley 881706-4321 MAILING ADDRESS 4007 Brae Burn Dr Bakersfield, Ca. 93306 Bruce W. Hinsley 661-706-4321 CERTIFICATION #:A25212 DATE & TIME TEST TO BE CONDUCTED ICC #: 8032698 SIGNATURE OF APPLICANT °' DATE 112012021 F --3 a 3 APPROVED BY FD 2095 (Rev. 09/05)