HomeMy WebLinkAboutTank Test App 4-15-16APPLICATION
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
❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT
❑ FUEL MONITORING CERTIFICATION
FACILITY NAME & PHONE # OF CONTACT PERSON
Mesa Marin Chevron Mohammud Muthana (661) 366 -4886
ADDRESS
11101 Highway 178, Bakersfield, CA 93306
OWNER NAME
Mohammud Muthana
OPERATOR NAME PERMIT TO OPERATE #
Mohammud Muthana
# OF TANKS TO BE TESTED:4 IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK # VOLUME CONTENTS
1 10,000 gal. Regular Unleaded (87)
2 10,000 gal. Plus Unleaded (89) .
3 10,000 gal. Premium Unleaded (91)
4 10,000 gal Diesel
04/12/2016
se' 9
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY DATE
FD2095 (Rev 03/08)