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HomeMy WebLinkAboutFMC APP 3.9.19APPLICATION 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 # 1 t © ENHANCED LEAK DETECTION Ci TANK TIGHTNESS VNE TESTING EL MONITORING CERTIFICATION BAKE FIELD FIRE DEPARTMENT Prevention :services 2101 H Street Bakersfield, CA 93301 Phone: 661- 326 -3979 * Fax: 661- 852 -2171 d/SB -989 SECONDARY CONTAINMENT 19 OVERFILL PREVENTION FACILITY NAME & PHONE # OF CONTACT PERSON Kem High School District Adrian Corral 661- 827 -3199 ADDRESS 3701 E. Belle Terrace, Bakersfield, CA. 93307 OWNER NAME Kern High School District OPERATOR NAME PERMIT TO OPERATE # Adrian Corral 661 - 827 -3199 # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? CJ YES 13 NO TANK* VOLUME CONTENTS 1 12,000 Gallons Unleaded 2 12,000 Gallons Diesel 3 1,000 Gallons Waste Oil FD2095 (Rev 03/18) < TANIK:TES'PEN1G `'C ®MPANlY TESTING COMPANY NAME & PHONE # OF CONTACT PERSON Cal Valley Equipment Jerry Rangel 661- 615 -4076 MAILING ADDRESS 7608 Frultvale 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 ` THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY I DATE FD2095 (Rev 03/18)