HomeMy WebLinkAboutFMC Application 7-22-21UNDERGROUND 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
8 FUEL MONITORING CERTIFICATION
SITE INFORMATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 • Fax: 661-852-2171
Page 1 of 1
❑ SB -989 SECONDARY CONTAINMENT
R OVERFILL PREVENTION
FACILITY
NAME & PHONE # OF CONTACT PERSON
#7705 Fastrip #641
Omero Garcia (661) 393-7000
ADDRESS
1200 Coffee Road
OWNER NAME
Jamieson Hill
OPERATOR NAME PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
T A N K #
VOLUME CONTENTS
1
12000
87 U N L
2
12000
91 U N L
3
12000
Diesel
TANK TESTING COMPANY
TESTING COMPANY NAME & PHONE # OF CONTACT PERSON
Confidence UST Services, Inc. Karli Karns (661) 631-3870
MAILING ADDRESS
16250 Meacham Road Bakersfield CA 93314
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
CERTIFICATION #
Payton Phillips (661) 234-6092
TEST METHOD
9482312
APPLICANT SIGNATU E
DATE
14)pi
06/18/21
,z0
THIS APPLICATION BECOMES
A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 09/20)