HomeMy WebLinkAbout3225 BUCK OWENS FMC APP 6.29.15UNDERGROUND STORAGE TANKS
A
NAME & PHONE * OF CONTACT PERSON
Corner Store # 3074
APPLICATION
FIRL R rAf r
TO PERFORM ELD/LINE TESTING/
OWNER NAME
SB989 SECONDARY CONTAINMENT
OPERATOR NAME
TESTING/TANK TIGHTNESS TEST AND
# OF TANKS TO BE TESTED:
FUEL MONITORING CERTIFICATION
TANK #
(please note that these are separate
CONTENTS
individual tests and vvill be charged per
14K
separate type test accordingly=)
T2
PERMIT #
Premium 91
T4
20K
-1000
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 e Fax: 661-852-2171
Page 1 of 1
❑ ENHANCED LEAK DETECTION LINE TESTING ❑ SB-989 SECONDARY CONTAINMENT
r-1 Ttrok- TTr.HTNF-qq FUEL MONITORING CERTIFICATION
SITE INFORMATION
FACILITY
NAME & PHONE * OF CONTACT PERSON
Corner Store # 3074
Manager (661) 324-9481
ADDRESS
3225 Buck Owens Blvd, Bakersfield, CA 93301
OWNER NAME
Corner Store
OPERATOR NAME
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ig YES ❑ NO
TANK #
VOLUME
CONTENTS
T1
14K
Regular 87
T2
10K
Premium 91
T4
20K
Diesel
TANK TESTING COMPANY
TESTING COMPANY
NAME & PHONE # OF CONTACT PERSON
Tanknology
Michelle Cleghorn, 951-676-4060
MAILING ADDRESS
41785 Enterprise Circle South Suite# D, Temecula, CA, 92590
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
CERTIFICATION #
Patrick Pfrang (512) 848-4140
ICC Service Technician
DATE & TIME TEST TO BE CONDUCTED
ICS' 4
5259475-UT
TEST METHOD
06/16/2015 @ 9am
APPLICANT SIGNATURE DATE
-
& 0 - 06/09/2015
L
TY kPPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/08)
$3lb I, I-