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HomeMy WebLinkAbout2016 989 Permit ApplicationUNDERGROUND 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 # 1146 O OO-3 ❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ TANK TIGHTNESS FUEL MONITORING CERTIFICATION BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661 - 326 -3979 • Fax: 661- 852 -2171 Page 1 of 1 X SB -989 SECONDARY CONTAINMENT SITE INFORMATION FACILITY: Bakersfield City Corp Yard. NAME & PHONE # OF CONTACT PERSON Adan 661 -326 -3795 ADDRESS 4101 Truxtun Avenue, Bakersfield OWNER NAME Bakersfield City OPERATOR NAME Adan PERMIT TO OPERATE # # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES X NO TANK # VOLUME CONTENTS 1 15,000 Unleaded 2 15,000 Diesel TANK TESTING COMPANY TESTING COMPANY Cal- Valley Equipment NAME & PHONE # OF CONTACT PERSON Jerry Rangel MAILING ADDRESS 3500 Gilmore Avenue, Bakersfield, CA. 93308 NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR Jerry Rangel CERTIFICATION # Incon 2710563701 DATE & TIME TEST TO BE CONDUCTED 01/13/15 @ 9:00 am ICC # 8160834 TEST METHOD Industry Standard APPLICANT SIGNATURE DATE 12/18/15 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE FD2095 (Rev 03/08)