HomeMy WebLinkAboutApplication 5-21-2020_4-9UNDERGROUND 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
0 FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 • Fax: 661-852-2171
Page 1 of 1
❑ SB -959 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
FD2095 (Rev 03/18)
SITE INFORMATION
FACILITY
Mesa Marin Chevron
NAME A PHONE .1 OF CONTACT PERSON
Mohammud Muthana (661) 3664886
ADDRESS
11101 Highway 178, Bakersfield, CA 93306
OWNER NAME
Mohammud Muthana
OPERATOR NAME
Mohammud Muthana
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES
❑ NO
TANK %
VOLUME
CONTENTS
1
10,000 gal.
87
2
10,000 gal.
87
3
10,000 gal.
91
4
10,000 gal.
DSL
TANK TESTING COMPANY
TESTING COMPANY
CONFIDENCE UST SERVICES, INC.
NAME E PHONEY Or CONTACT POUPOK
Karo Kams (881) 631-3970
MAILING ADDRESS
16250 MEACHAM ROAD, BAKERSFIELD. CA 93314
NAME® PHONE i OF TESTER OR SPECIALINSPECTOR
Aaron Pemgo (661) 304-2913
CERTIFICATION
TEST METHOD
ICC I
8485827
PLICANT SWNATD
DATE
04)14/2020
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/18)