HomeMy WebLinkAboutFMC Application 5-4-21PERMIT NO.
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT TESTING
❑ TANK TIGHTNESS TEST X TO PERFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Protection Testing
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FACILITY SamC0
NAME & PHONE NUMBER OF CONTACT PERSON
ADDRESS 1131 Oak st Bakersfield, Ca,
OWNERS NAME Same
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OPERATORS NAME Same
PERMIT TO OPERATE NO.
NUMBER OF TANKS TO BE TESTED
IS PIPING GOING TO BE TESTED?
❑ YES
❑ NO
TANK #
VOLUME
CONTENTS
1
87 UL
2
87 UL
87 UL
3
4
91 UL
Diesel
g
TANK TESTING COMPANY
Bruce W. Hinsley 661-706-4321
NAME OF TESTING COMPANY Advanced Compliance
MAILING ADDRESS 4007 Brae Burn Dr. Bakersfield, Ca. 93306
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Bruce W. Hinsley 66'1-706-4321
CERTIFICATION #:A25212
DATE & TIME TEST TO BE CONDUCTED
ICC #: 8032698
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SIGNATURE OF APPLICANT €
DATE 1/20/2021
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APPROVED BY
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DATE
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1
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