HomeMy WebLinkAboutFMC Application10-7-21UNDERGROUND 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 #
1.
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 * Fax: 661-852-2171
Page 1 of 1
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT
❑ TANK TIGHTNESS FUEL MONITORING CERTIFICATION ❑ OVERFILL PREVENTION
INFORMATION
SITE 1 1, i
FACILITY
NAME & PHONE # OF CONTACT PERSON
Sully's (Olive Drive @ Calloway)
Tim Sullivan, Jr. (661) 327-5008
ADDRESS
9709 Olive Dr Bakersfield, CA 93312
OWNER NAME
Petroleum Company
.-Sullivan
OPERATOR NAME
PERMIT TO OPERATE #
Tim Sullivan, Jr.
# OF TANKS TO BE TESTED:2
IS PIPING GOING TO BE TESTED? ® YES 0 NO
T A N K #
VOLUME
CONTENTS
1
207 000
87
2
1 2,000
91
3
12,000
Diesel
TANK TESTING COMPANY
TESTING COMPANY
NAME & PHONE # OF CONTACT PERSON
Advanced Compliance
Leann Hamilton 661-808-5323
MAILING ADDRESS
4007 Brae Burn Dr Bakersfield Ca
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
CERTIFICATION #
Bruce Hinsley
A25212
TEST METHOD
ICC #
PEI RP1200-17
8032698
APPLICANT SIGNATURE
DATE
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 09/20)