HomeMy WebLinkAbout10-6-21_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 # I
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING
❑ TANK TIGHTNESS ❑ FUEL MONITORING CERTIFICATION
®A VLPEP�MR.G..Z7F.LGLD FIRE MRTENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 • Fax: 661-852-2171
Page 1 of 1
❑ SB -989 SECONDARY CONTAINMENT
8 OVERFILL PREVENTION
SITE INFORMATION
FACILITY
UNION VALERO
NAME & PHONE # OF CONTACT PERSON
ERNESTO / 661-706-7423
ADDRESS
1129 UNION AVE
OWNER NAME
OPERATOR NAME
ERNESTO
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES 8 NO
T A N K #
VOLUME
CONTENTS
1
10,000
87
2
10,000
91
8
10, 00 0
D1 ESE`
TANK TESTING COMPANY
TESTING COMPANY
BSSR INC,
NAME & PHONE # OF CONTACT PERSON
FIDEL CARRILLO
MAILING ADDRESS
6630 ROSEDALE HWY #B
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
FIDEL CARRILLO / 661-588-2777
CERTIFICATION #
5257282
TEST METHOD
VISUAL
ICC #
5257282
APPLICANT SIGNATURE
C
DATE
8/30/2021
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 09/20)