HomeMy WebLinkAboutFMC Permit App 1-30-17UNDERGROUND 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 # LiWOM022
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
B 8 R S F I A
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❑ LINE TESTING
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 ' IN FORMATION'
FACILITY: Kern High School District
NAME & PHONE # OF CONTACT PERSON
Adrian 661 -827 -3199
ADDRESS
3701 E Belle Terrace, Bakersfield
OWNER NAME
Kern High School District
OPERATOR NAME
Adrian
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES X NO
TANK #
VOLUME
CONTENTS
1
12,000
Unleaded
2
12,000
Diesel
3
1,000
Used Oil
TANK 'TESTING . COMPANY
TESTING COMPANY
Cal- Valley Equipment
NAME & PHONE # OF CONTACT PERSON
Jerry Rangel
MAILING ADDRESS
7608 Fruitvale Avenue, Bakersfield, CA. 93308
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Jerry Rangel
CERTIFICATION #
Veeder Root: B35460
DATE & TIME TEST TO BE CONDUCTED
TBD
ICC #
8160834
TEST METHOD
Industry Standard
APPLICANT SIGNATURE
—
DATE
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THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/08)