HomeMy WebLinkAboutFMC APP 3.4.19APPLICATION
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 #
❑ 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
❑ SB -989 SECONDARY CONTAINMENT
OVERFILL PREVENTION
FACILITY NAME & PHONE # OF CONTACT PERSON
Bakersfield City Corp Yard Miguel Hererra (661) 326 -3785
ADDRESS
4101 Truxtun Avenue, Bakersfield, CA. 93309
OWNER NAME
City of Bakersfield
OPERATOR NAME PERMIT TO OPERATE #
Miguel Hererra
# OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK# VOLUME CONTENTS
1 15,000 Unleaded
2
15,000 1 Diesel
TESTING COMPANY NAME & PHONE # OF CONTACT PERSON
Cal Valley Equipment Jerry Range[ 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: B35460, OPW:0128241, Incon: 1037433709
TEST METHOD ICC #
Industry Standard 8160834
APPLICANT SIGNATLMZ --, DATE
, -Lim ( 01
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY I DATE
FD2095 (Rev 03/18)