HomeMy WebLinkAboutAPPLICATION 11-17-2020UNDERGROUND 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 #
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
G P-0
❑ LINE TESTING
8 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
Brookside Market (Riverlakes)
NAME & PHONE # of CONTACT PERSON
Jerry Rangel 661-615-4076
ADDRESS
7608 Fruitvale Avenue, Bakersfield, CA. 93308
OWNER NAME
Jeffries Bros. Inc.
OPERATOR NAME
Matt Jeffries
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED: 3
IS PIPING GOING TO BE TESTED? ❑ YES B NO
T A N K #
VOLUME
CONTENTS
1
215000
Unleaded
2
97000
Premium
3
20,000
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 661-979-0953
CERTIFICATION #
Veeder Root: B35460
TEST METHOD
Industry Standard
TCC #
89008324
APPLICANT SIGNATURE
DATE
t Z -
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 09/20)