HomeMy WebLinkAboutApplication 2-16-22UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD/LINE TESTING/
SB989 SECONDARY CONTAINMENT
TESTING/TANK TIGHTNESS TEST AND
FUEL MONITORING CERTIFICATION
(Please nate that these are separate
individual tests and will be charged per
separate type test accordingly.)
PERMIT #
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
❑ LINE TESTING
M 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
Arco
NAME & PHONE # OF CONTACT PERSON
ADDRESS
1819 E. Brundage Lane, 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
1
87/91
2
diesel
TANK TESTING COMPANY
TESTING COMPANY
BSSR, Inc.
NAME & PHONE # OF CONTACT PERSON
Fidel Carrillo 588-2777
MAILING ADDRESS
6539 Rosedale Hwy. #B, Bakersfield, CA 93308
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Fidel Carrillo
CERTIFICATION #
TEST METHOD
ICC #
5257282
APPLICANT SI TU i
.-
DATE
1-28-22
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 09/20)