HomeMy WebLinkAboutApplication SB 989 10-30-2020_4-4UNDERGROUND 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 #
1001�
BR S F I D
FIRE
E E
if r
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 • Fax: 661-852-2171
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❑ ENHANCED LEAK DETECTION ❑ LINE TESTING B-989 SECONDARY CONTAINMENT
❑ TANK TIGHTNESS R FUEL MONITORING CERTIFICATION
SITE INFORMATION
FACILITY
Sprint Telecommunications
NAME & PHONE # OF CONTACT PERSON
ADDRESS
715 E. Sumner St.
OWNER NAME
Sprint Telecommunications
OPERATOR NAME
Sprint Telecommunications
PERMIT TO OPERATE
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK #
VOLUME
CONTENTS
1
550
Diesel
TANK TESTING COMPANY
TESTING COMPANY
Jauregui & Culver, Inc.
NAME & PHONE # OF CONTACT PERSON
Bianca Gonzalez (760) 743-0518
MAILING ADDRESS
959 W. Mission Ave.
NAME & PHONE = OF TESTER OR SPECIAL INSPECTOR CERTIFICATION #
Benjamin Jaure ui/ 760 638-6511 VR Technician B44005
DATE & TIME TEST TO BE CONDUCTED
October 14, 2020 @ 9am
ICC #
8277373
TEST METHOD
CA State
APPLICANT SIGNATURE
vc�=5�yu4k,
DATE
September 14, 2020
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 12/15)