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HomeMy WebLinkAboutUST APPL 10/22/2014UNDERGROUND 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 # fe- W� Pi B E R S 12 D FAWN��. ter. -. BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661- 326 -3979 . Fax: 661- 852 -2171 Page 1 of 1 ❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT ❑ TANK TIGHTNESS OR FUEL MONITORING CERTIFICATION SITE INFORMATION FACILITY Penske# CA -094 NAVIE & PHONE # OF CONTACT PERSON Brian Yazemboski, 610 - 603 -8450 ADDRESS 2929 East Brundage, Bakersfield, CA, 93307 OWNER NAME Penske OPERATOR NAME Brian Yazemboski PERMIT TO OPERATE # unknown # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? 11 YES 0 NO TANK # VOLUME CONTENTS 1 11,594 gallons Diesel fuel 2 11,594 gallons Diesel fuel TANK TESTING COMPANY TESTING COMPANY Tanknology NAME & PHONE # OF CONTACT PERSON Aaron W. Medina, 951 - 676 -4060 MAILING ADDRESS 41785 Enterprise Circle South Suite# D, Temecula, CA, 92590 NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR Edwin Pineda, 602 -316 -2772 CERTIFICATION # lCC Service Technician DATE & TIME TEST TO BE CONDUCTED 12/1/14, 9:00am ICC # 8026748 -UT TEST METHOD APPLICANT 341VATURE DATE 10/22/14 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE FD2095 (Rev 03/08)