HomeMy WebLinkAboutApplication 12-19-19_4-87u-:�,A
UNDERGROUND 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 # D
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
❑ LINE TESTING
IR FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 X Fax: 661-852-2171
Page 1 of 1
❑ SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
SUE INFORMATION
FACILITY
CIRCLE K # 2701270
NAME a PHONE X OF CONTACT PERSON
YOLANDA JONES 602-728-8000
ADDRESS
STINE RD BAKERSFIELD, CA
0ZR NAME
CIRCLE K STORES INC
OPERATOR NAME
CIRCLE K
PERMIT TO OPERATE *
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES NO
TANK X
VOLUME
CONTENTS
TANK TESTING COMPANY
TESTING COMPANY
B&T SERVICE STATION CONTRACTORS
NAME a PHONE X OF CONTACT PERSON
MARCUS GARCIA 805-929-8944 EX 1012
MAILING ADDRESS
630 S FRONTAGE RD NIPOMO, CA. 93444
NAME N PHONE i OF TESTER OR SPECIAL INSPECTOR
RICKEY BINGER 805-431-0332
CERTIFICATION*
TEST METOD
ICC X
84526 29
A SIGN UR
DATE
11/27/2019
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
F02095 1. 03118)