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HomeMy WebLinkAboutLine Test App 11-7-16UNDERGROUND 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 he charged per separate type test accordingly.) PERMIT # l6 -1 &s ❑ ENHANCED LEAK DETECTION ® 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? 'eld YES 11 NO TANK # VOLUME CONTENTS al Diesel 10/26/2016 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE FD2095 (Rev 03/08) BAKERSFIELD FIRE DEPARTMENT Prevention Services B B x s F_I,_a 2101 H Street AlAff Bakersfield, CA 93301 ARfR f Phone: 661 - 326 -3979 ® Fax: 661- 852 -2171 Page 1 of 1 ® 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? 'eld YES 11 NO TANK # VOLUME CONTENTS al Diesel 10/26/2016 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE FD2095 (Rev 03/08)