HomeMy WebLinkAboutFMC APP 11.21.19UNDERGROUND 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
i cimidDal tests and will be charged per
separate type test accordingly.)
PERMIT #
❑ ENHANCED LEAK DETECTION
❑ TANKTIGHTNESS
❑ UNETESTING
IR FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 - 326 -3979 A Fax: 661 -852 -2171
Page 1 of 1
❑ SB -989 SECONDARY CONTAINMENT
❑ OVERHU-PREVENRON
SITE INFORMATION
FACIUTY
CIRCLE K #2708605
NAME A PHONE a Of CONTACT PERSON
YOLANDA JONES
ADDRESS
5600 AUBURN ST BAKERSFIELD
OWNER NAME
CIRCLE K STORES INC
OPERATOR NAME
CIRCLE K # 2708605
PERMIT TO OPERATE 8
# OF TANKS TO BE TESTED:
15 PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
TANK TESTING COMPANY
TESTING COMPANY
B &T SERVICE STATION CONTRACTORS
NAME A PHONE 8 OF CONTACT PERSON
MARCUS GARCIA 805- 929 -8944 EX 1012
MAILING ADDRESS
630 S FRONTAGE RD
NAME® PHONE 80F TESTER OR SPECIAL INSPECTOR
JAMES VVELSCH
CERTIFICATION
8201843
TEST METHOD
TCC E
8201843
APPLICANT SIGNATURE
DATE
10/16/2019
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED eY
DATE
FD2095 (Rev 03 /18)