HomeMy WebLinkAboutfmc Application 4-28-22UNDERGROUND 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
Q[Pk
❑ LINE TESTING
0 FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 • Fax: 661-852-2171
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0 SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
FD2095 (Rev 03/18)
SITE INFORMATION
FACILITY
Jaco #9933/Fastrip #660
NAME & PHONE # OF CONTACT PERSON
Omero Garcia, 661-428-5457
ADDRESS
4800 Fairfax Road
OWNER NAME
Omero Garcia, 661-428-5457
OPERATOR NAME
Omero Garcia, 661-428-5457
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES
❑ NO
TANK #
VOLUME
CONTENTS
1
12,000 gal.
87
2
12,000 gal.
91
3
12,000 gal.
DSL
TANK TESTING COMPANY
TESTING COMPANY
Nwestco LLC dba Confidence UST Services
NAME & PHONE # OF CONTACT PERSON
Karli Karns (661) 631-3870
MAILING ADDRESS
2209 Zues Court, Bakersfield, CA 93308
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Ron Clark (661) 525-3825
CERTIFICATION #
ICC
TEST METHOD
ICC #
9482314
APPLICANT SIGNATURE
DATE
04/05/22
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/18)