HomeMy WebLinkAboutApplication SB989 2-25-21APPLICATION
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 # 10025545
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 * Fax: 661-852-2171
Page I of 1
1:1 ENHANCED LEAK DETECTION El LINE TESTING [Z SB -989 SECONDARY CONTAINMENT
0 TANK TIGHTNESS El FUEL MONITORING CERTIFICATION El OVERFILL PREVENTION
SITE INFO RM ATION
FACILITY NAME PHONE # OF CONTACT PERSON
Costco Wholesale #688 Dennis Bock 425-922-9700
ADDRESS
3800 Rosedale Hwy., Bakersfield CA 93308
OWNER NAME
Dennis Bock
I PERMIT TO OPERATE #
OPERATOR NAME
Dennis Bock 10025545
# OF TANKS TO BE TESTED:
— -- -------- ---
IS PIPING GOING TO BE TES TED?
IKI YES 0 NO
TANK #
VOLUME
CONTENTS
T 1 8 7
2 0, 000
Gasoline
T2 87
i20,000
Gasoline
T3 91
20 000
Gasoline
T5 Diesel
10.'000
Diesel
TANK TESTING COMPANY
TESTING COMPANY NAME & PHONE # OF CONTACT PERSON
Belshire Environmental Services, Inc. Jim Brown 949-460-5200
MAILING ADDRESS
25971 Towne Centre Drive
. . ....... .........
NAME & PHONE OF TESTER OR SPECIAL INSPECTOR CERTIFICATION #
808313
Inffrn'ti nof4f4arc QAQ-Agn-,;?nn
#
TEST METHOD ICC
5252456
manufacturer/Industry Standard
01gaally Vgne?l tq Jim, Frown
APPLICANT SIGNATURE
ON. cn=Jim Brown, c=us, o=Beish�re
DATE
JiMbrown Reason: I am approving this doccurnent
Lmat�on- Foothil Ranch, CA
Date, 202101,12 11-21.41 -06W 1/ 1 1/ 202 1
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY DATE
FD2095 (Rev 03/18)