HomeMy WebLinkAboutMINOR APP 2.25.19UNDERGROUND 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 #
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING
❑ TANK TIGHTNESS ❑ FUEL MONITORING CERTIFICATION
BAKERSFIELD 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
12 OVERFILL PREVENTION
SITE INFORMATION
FACILITY
CIRCLE K# 2701270
NAME & PHONE # OF CONTACT PERSON
MARCUS GARCIA 805 - 929 -8944 EX 1012
ADDRESS
5364 STINE RD BAKERSFIELD
OWNER NAME
CIRCLE K STORES INC.
OPERATOR NAME
CIRCLE K STORES INC.
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES NO
TANK #
VOLUME
CONTENTS
T - 2 PREMIUM 91
11849
premium unleaded
TANK TESTING COMPANY
TESTING COMPANY
B &T SERVICE STATION CONTRACTORS
NAME & PHONE # OF CONTACT PERSON
MARCUS GARCIA 805 -929 -8944 EX 1012
MAILING ADDRESS
630 S FRONTAGERD NIPOMO, CA. 93444
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
JAMES WELSCH OPW PHASE 1
CERTIFICATION #
101237
TEST METHOD
VISUAL/ MEASURE
ICC #
8201843
APPLICANT SIGNATURE
DATE
12/11/2019
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/18)