HomeMy WebLinkAboutSB 989 Application 8-5-21UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD/LINE TESTING/
SB989 SECONDARY CONTAINMENT
TESTING/WANK TIGHTNESS TEST AND
FUEL MONITORING CERTIFICATION
(Please note that these are separate
individual tests and will be charged per
separate type test accordingly.)
PERMIT #
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❑ 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 • Fax: 661-852-2171
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8 SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
SITE INFORMATION
FACILITY NAME & PHONE # OF CONTACT PERSON
Pan Pacific[World oil Dave - 589-3200
ADDRESS
1850 Coffee Rd, Bakersfield CA 93308
OWNER NAME
OPERATOR NAME
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
T A N K #
VOLUME
CONTENTS
Diesel
TANK TESTING COMPANY
TESTING COMPANY
BSSR, Inc.
NAME & PHONE # OF CONTACT PERSON
Kelly Tackett 588-2777
MAILING ADDRESS
6630 Rosedale Hwy. #B Bakesfield, CA 93308
E NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Fidel Carrillo
CERTIFICATION #
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TEST METHOD
APPLICAN SIGNATURE
5257282
DATE
4-26-21
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 09/20)