HomeMy WebLinkAbout4101 truxtun ave 989 retest 4-28-16_3-4UNDERGROUND STORAGE TANKS
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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 # l & _ x
❑ 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
NAPE & PHONE # OF CONTACT PERSON
Jerry Range)
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
TBD
ICC #
8160834
TEST METHOD
Industry Standard
APPLICANT SI JRE
DATE
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/08)