HomeMy WebLinkAbout3-12-19 ApllicationAPPLICATION
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 ❑ LINE TESTING
❑ TANK TIGHTNESS ❑ FUEL MONITORING CERTIFICATION
BAKE FIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 ® Fax: 661-852-2171
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❑ SB -989 SECONDARY CONTAINMENT
OVERFILL PREVENTION
FACILITY NAME & PHONE # OF CONTACT PERSON
Arco Am/Pm Raja Singh (209) 634-4832
ADDRESS
6450 White Lane, Bakersfield, CA. 93309
OWNER NAME
Raja Singh
OPERATOR NAME PERMIT TO OPERATE #
Raja Singh (209) 634-4832
# OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK# VOLUME CONTENTS
1 12,000 Gallons 87 Unleaded
2 12,000 Gallons 87 Unleaded
3 12,000 Gallons 91 Unleaded
TESTING COMPANY NAME & PHONE # OF CONTACT PERSON
Cal Valley Equipment Jerry Rangel 661-615-4076
MAILING ADDRESS
7608 Fruitvale Avenue, Bakersfield, CA. 93308
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR CERTIFICATION #
Jerry Rangel 661-979-0953 Veeder Root: 835460, OPW:0128241, Incon: 1037433709
TEST METHOD ICC #
Industry Standard 8160834
APPLICANT SIGNATURE DATE
1Z
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY I DATE
FD2095 (Rev 03/18)