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HomeMy WebLinkAboutPermit App 6-17-16UNDERGROUND 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 # I ' t "'100oo. p ❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ TANK TIGHTNESS X 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 SB -989 SECONDARY CONTAINMENT SITE INFORMATION FACILITY: Fed Ex Freight NAME & PHONE # OF CONTACT PERSON Jeff 661 - 837 -0997 ADDRESS 6100 District Blvd. OWNER NAME Fed Ex OPERATOR NAME Jeff Fleming PERMIT TO OPERATE # # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES X NO TANK # VOLUME CONTENTS 1 12,000 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 # Veeder Root: 835460 DATE & TIME TEST TO BE CONDUCTED 06/17/16 @ 9:00 am ICC # 8160834 TEST METHOD Industry Standard APPLICANT SIGN URE DATE g —_ . 4 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE FD2095 (Rev 03/08)