HomeMy WebLinkAboutSB989 10-8-21_4-5UNDERGROUND 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 #
171 ENHANCED LEAK DETECTION ❑ LINE TESTING
0 TANK TIGHTNESS ❑ FUEL MONITORING CERTIFICATION
SITE JNFORMATION,
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield,, CA 93301
Phone: 661-326-3979 9 Fax: 661-852-2171
Page 1 of 1
R1 SB -989 SECONDARY CONTAINMENT
0 OVERFILL PREVENTION
FACILITY
VG MINI MARKET
NAME & PHONE # OF CONTACT PERSON
RAUSHANI NARANG (661) 549-0779
ADDRESS
6501 S Union Ave Bakersfield, CA 93307
OWNER NAME
RAUSHANINARANG
OPERATOR NAME
NARANG-----,.--
PERMIT TO OPERATE #
-RAUSHANI.
# OF TANKS TO BE TESTED:2
BE TETED? 19 YES 0 NO
IS PIPING GOING TO S
T A N K #
VOLUME
CONTENTS
n
12, 00U
87 1
2
5 000
7
Diesel
3
77000
91
TANK TESTING. COMPANY
TESTING COMPANY
Advanced Compliance
NAME & PHONE # OF CONTACT PERSON
Leann Hamilton 661-808-5323
MAILING ADDRESS
4007 Brae Burn Dr Bakersfield Ca
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Bruce Hinsley
CERTIFICATION #
A25212
TEST METHOD
PEI RP1200-17
ICC #
8032698
APPLICANT SIGNATURE
DATE
01
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 09/20)