HomeMy WebLinkAboutApplication 9-24-2020_4-8UNDERGROUND STORAGE TANKS
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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 #
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING
❑ TANK TIGHTNESS 'FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 9 Fax: 661-852-2171
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❑ SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
SITE INFORMATION
FACILITY
Fed Ex
NAME & PHONE # OF CONTACT PERSON
Jeff Fleming 661-837-0997
ADDRESS
6100 District Blvd., Bakersfield, CA. 93313
OWNER NAME
Fed Ex
OPERATOR NAME
Jeff Fleming
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
1
12,000
Diesel
TANK TESTING COMPANY
TESTING COMPANY
Cal Valley Equipment
NAME & PHONE # OF CONTACT PERSON
Jerry Rangel 661-615-4076
MAILING ADDRESS
7608 Fruitvale Avenue, Bakersfield, CA. 93308
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Jerry Rangel
CERTIFICATION #
Veeder Root: B35460, OPW: 0128241, Incon: 1037433709
TEST METHOD
Industry Standard
ICC #
8900834
APPLICANT SIGNATURE
DATE �.
r� THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/18)