HomeMy WebLinkAboutFMC Application 5-6-22UNDERGROUND 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 # I I
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING
❑ TANK TIGHTNESS FUEL MONITORING CERTIFICATION
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 * Fax: 661-852-2171
Page I of 1
❑ SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
SITE INFORMATION'
FACILITY
Rosedale Chevron
NAME & PHONE # OF CONTACT PERSON
NIRMAL GILL (661) 345-3859
ADDRESS
9700 Rosedale Hwy Bakersfield, CA 93312
OWNER NAME
NIRMAL GILL
OPERATOR NAME
NIRMAL GILL
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:3
IS PIPING GOING TO BE TESTED? ® YES ❑ NO
T A N K #
VOLUME
CONTENTS
1
12,000
87
2
10, 000
87
3
121000
Diesel
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
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 09/20)