HomeMy WebLinkAboutFMC Application 5-12-21PERMIT NO.
n ENHANCED LEAK DETECTION n LINE TESTING El SB -989 SECONDARY CONTAINMENT TESTING
El TANK TIGHTNESS TEST X TO PERFORM FUEL MONITORING CERTIFICATION F-1 Cathodic Protection Testing
SITE INFORMATION
NAME & PHONE NUMBER OF CONTACT PERSON
FACILITY Fairview Truck Stop
ADDRESS 300 Fairview Rd. Bakersfield, Ca.
OWNERS NAME Same
OPERATORS NAME Same PERMIT TO OPERATE NO.
F
NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED?
TANK # VOLUME
0 YES LJ NO
CONTENTS -
UNDERGROUND STORAGE TANKS
BAKERSFIELD FIRE DEPT.
E R S F I
Prevention Services
FIRS
uxtun Ave., 1 st Floor
PPL [CATION
:field, CA 93301
Tj PERFORM ELD I LINE TESTING
-)61) 326-3979
/ *15989 SECONDARY CONTAINMENT TESTING 561) 852-2171
/TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMIT NO.
n ENHANCED LEAK DETECTION n LINE TESTING El SB -989 SECONDARY CONTAINMENT TESTING
El TANK TIGHTNESS TEST X TO PERFORM FUEL MONITORING CERTIFICATION F-1 Cathodic Protection Testing
SITE INFORMATION
NAME & PHONE NUMBER OF CONTACT PERSON
FACILITY Fairview Truck Stop
ADDRESS 300 Fairview Rd. Bakersfield, Ca.
OWNERS NAME Same
OPERATORS NAME Same PERMIT TO OPERATE NO.
F
NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED?
TANK # VOLUME
0 YES LJ NO
CONTENTS -
DSL.
TANK TESTING COMPANY.
NAME OF TESTING COMPANY Advanced Compliance I Bruce W. Hinsiey 661-706-4321
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 %-0110A ii /I _U1, rvs&A
DATE 1/20/2021
APPROVED BY I DATE —
FD 2095 (Rev. 09105)