HomeMy WebLinkAboutApplication 10-8-2019 OPI6450_4-4UNDERGROUND 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 # I
❑ ENHANCED LEAK DETEMON ❑. LINE TESTING
❑ TANK TIGHTNESS ❑ FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 r Fax: 661-852-2171
Page 1 of 1
❑ SB -989 SECONDARY CONTAINMENT
9OVERFILL PREVENTION ✓% "Ai Ii c +a)1 �
SITE INFORMATION
FACILITY
NAatE S AHONE # Of CONTACT PERSON
Arco AmIla n
Raja Singh (209) 6344832
ADDRESS
6450 White Lane, Bakersfield, CA. 93309
V.D. NAME
Raa Singh
OPERATOR NAME PERMIT TO OPERATE A
Raja Singh ---
a OF TANKS TO BE TESTEE:::�-S
PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
1
12,000 gallons
Unleaded
2
12,000 gallons
Unleaded
3
12,000 gallons
Unleaded
TANK TESTING COMPANY
TESTING COMPANY NAME & PPORM 4 OF CONTACT PERSON
Cal Valle E uiprnent Jer Rangel 661-615-0076
MAILING ADDRESS
7608 Fruitvale Avenue BakersFiEr CA. 93308
NAME & PHONE 4 OF TESTER OR SPECIAL INSPECTOR
CERTIFICATION d
Veetler Roo[ 035460, OPW 0128241, Inwn_1037433709
Jerry Range] _—
SCC tt
TEST METHOD
160634
8160834----
Industry Standard
DATE
APPLICANT SIGNATURE
APPLICANT
^�
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
F02095 (Rev 03118)