HomeMy WebLinkAboutApplication 10-21-2020 _4-8UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD/LINE TESTING/
SB -89 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
❑ TANK TIGHTNESS
❑ LINE TESTING
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 -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
SITE INFORMATION
FACILITY
Arco AM/PM
NAME & PHONE # OF CONTACT PERSON
Raja 299 996-6245
ADDRESS
7851 Rosedale Hwy.
OWNER NAME
OPERATOR NAME
PERMIT TO OPERATE"
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
1
U/L
2
U/L
3
Prem
TANK TESTING COMPANY
TESTING COMPANY
BSSR, Inc.
NAME & PHONE # OF CONTACT PERSON
Kelly Tackett 588-2777
MAILING ADDRESS
6639 Rosedale Hwy. #B, Bakersfield, CA 93308
NAME & PHONE = OF TESTER OR SPECIAL INSPECTOR
Fidel Carrillo
CERTIFICATION #
TEST METHOD
#
5257282
APPLI ANT SIG ,, NATURE
DATE
9-20-20
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 03/18)