HomeMy WebLinkAboutFMC Application 4-25-22UNDERGROUND STORAGE TANKS
r
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
]) FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 9 Fax: 661-852-2171
Page 1 of 1
❑ SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
SITE INFORMATION
FACILITYME
USA Liquor
JcR64_8O # FCO T PERSON '
Kana 32-64t``l
All j��o S Union, Bakersfield
OWNER NAME
Ali Korin
OPERATOR NAME
Same
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES NO
TANK #
VOLUME
CONTENTS
Tank 1
Tank 2
Tank 3
TANK TESTING COMPANY
TESTING COMPANY
LC Services
NAME & PHONE # OF CONTACT PERSON
Bobbie Frank 559-444-1730
_
MAILING ADDRESS
3887 N. Valentine Fresno CA 93722
NALAE & PjiOff0R SPECIAL INSPECTOR
C;HARLr§T§H RL
_
CERTIFICATION #
B47431
TEST METHOD
In on
ICC #
8357758
APPLICAN ATUR
DATE
2/25/22
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/18)