HomeMy WebLinkAboutFMC APP 10-1-18UNDERGROUND STORAGE TANKS
4 +.
NAME & PHONE # OF CONTACT PERSON
Matt Jeffries 661- 387 -0592
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APPLICATION.. ,
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TO PERFORM ELD /LINE TESTING/
# OF TANKS TO BE TESTED:
SB989 SECONDARY CONTAINMENT
TANK #
TESTING /TANK TIGHTNESS TEST AND
CONTENTS
FUEL MONITORING CERTIFICATION
10,000
(Please note that these are separate
2
individual tests and will be charged per
87 Unleaded
separate type test accordingly.)
10,000
PERMIT #
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
❑ LINE TESTING
XFUEL 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: Brookside Market and Deli
NAME & PHONE # OF CONTACT PERSON
Matt Jeffries 661- 387 -0592
ADDRESS
4700 Coffee Road, Bakersfield, CA.
OWNER NAME
Jeffries Brothers Inc.
OPERATOR NAME
Matt Jeffries
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES X NO
TANK #
VOLUME
CONTENTS
1
10,000
91 unleaded
2
10,000
87 Unleaded
3
10,000
87 Unleaded
4
10,000
Diesel
TANK TESTING COMPANY
TESTING COMPANY
Cal - Valley Equipment
NAME & PRONE # 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: 635460
DATE & TIME TEST TO BE CONDUCTED
09/13/18 @ 9:00 am
ICC #
8160834
TEST METHOD
Industry Standard
APPLICA�NT SSI�G�N�A
DATE J
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/08)