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HomeMy WebLinkAboutFMC Application 5-5-21UNDERGROUND STORAGE TANKS PERMIT NO. ❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT TESTING ❑ TANK TIGHTNESS TEST X TO PERFORM FUEL MONITORING CERTIFICATION ❑ Cathodic Protection Testing NAME & PHONE NUMBER OF CONTACT PERSON RC FACILITY 4010 ARCO ADDRESS 4010 Wible Rd. Bakersfield, Ca. OWNERS NAME Same OPERATORS NAME Same PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO TANK # VOLUME CONTENTS E 1 87 UL 2 3 87 UL 91 UL 4 DSL a TANK TESTING COMPANY NAME OF TESTING COMPANY Advanced Compliance Bruce W. Hinsley 661-706-4321 E, MAILING ADDRESS 4007 Brae Burn Dr Bakersfield, Ca. 93308 Bruce W. Hinsley 861-70+6-4321 CERTIFICATION #:A25212 { DATE & TIME TEST TO BE CONDUCTED ICC #: 8032698 - SIGNATURE OF APPLICANT. DATE 1/20/2021 ��- -��"- APPROVED BY DATE ru LVtlJ kRCV. V5/V:J)