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HomeMy WebLinkAboutOPI Application 3-28-22UNDERGROUND 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 ❑ TANK TIGHTNESS 'S F� EPk ❑ LINE TESTING ❑ 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 FD2095 (Rev 09/20) SITE INFORMATION FACILITY Arco Am/Pm NAME & PHONE # OF CONTACT PERSON ADDRESS 900 Monterey Bakersfield, CA 93305 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 12,000 87 2 3 121000 12,000 87 91 TANK TESTING COMPANY TESTING COMPANY BSSR, Inc. NAME & PHONE # OF CONTACT PERSON Kelly Tackett 588-2777 MAILING ADDRESS 6630 Rosedale Hwy. #B Bakersfield, CA 93308 NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR Salvador Sanchez CERTIFICATION # TEST METHOD 'CC 5309490 APP ANT SIGNATURE - DATE 3-3-22 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE FD2095 (Rev 09/20)