HomeMy WebLinkAboutFMC 10-29-21_4-8UNDERGROUND 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 #
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 ERFIL ION
SITE INFORMATION
FACILITY
Pacific Bell Telephone Co. dba AT&T California
NAME & PHONE # OF CONTACT PERSON
Adolfo Aguilar (661) 361-4408
ADDRESS
1520 20th Street, Bakersfield, CA 93301
OWNER NAME
Pacific Bell Telephone Co. dba AT&T California
OPERATOR NAME
AT&T
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES NO
lTANK #
I VOLUME
I CONTENTS
SA002UO01
8,000 Gallons
Diesel
TANK TESTING COMPANY
TES-iNG COMPANY
Tait Environmental Services, Inc.
NAME & PHONE # OF CONTACT PERSON
Carlos Cardenas (714) 567-6418
h1AILING ADDRESS
701 N. Parkcenter Drive, Santa Ana; CA 92705
NAN' E & PHONE # OF TESTER OR SPECIAL INSPECTOR
Patrick Banbury 714-920-5476
CERTIFICATION #
Incon TS -STS 1001733709
TEST METHOD
RP -1200
ICC #
5254955
APPLICANT SIG1`4ATURE DATE
a"44— C,4 C 09/09/2021
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/18)