HomeMy WebLinkAboutFMC Application 3-22-22UNDERGROUND 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 #
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING
❑ TANK TIGHTNESS 8 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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❑ SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
FD2095 (Rev 09/20)
SITE INFORMATION
FACILITY
ARCO
NAME & PHONE # OF CONTACT PERSON
ADDRESS
2800 PANAMA LANE, BAKE RS F I ELD, CA
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
2
3
87
87
4
91
TANK TESTING COMPANY
TESTING COMPANY
BSSR, INC.
NAME & PHONE # OF CONTACT PERSON
FIDEL CARRILLO 205-2773
MAILING ADDRESS
0630 ROSEDALE HWY. #B, BAKERSF I ELD, CA 93308
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
NATHAN HOLMAN
CERTIFICATION #
TEST METHOD
ICC #
8111067
APP CANT'SjtNA
DATE
1-28-22
0
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 09/20)