HomeMy WebLinkAboutCOLD START Application 5-13-22UNDERGROUND 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
SITE INFORMATION
FACILITY
7 -Eleven #32241
NAME & PHONE # OF CONTACT PERSON
Manager (661) 322-3146
ADDRESS
2929 E. BRUNDAGE, BAKERSFIELD, CA 93307
OWNER NAME
PENSKE CA -094
OPERATOR NAME
PENSKE CA -094
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
T A N K #
VOLUME
CONTENTS
T4
15K
REG Unleaded
T5
10K
Premium
TANK TESTING COMPANY
TESTING COMPANY
Tanknology
NAME & PHONE # OF CONTACT PERSON
Mark Lindsey 951-676-4060
MAILING ADDRESS
41785 Enterprise Cide South #D
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Luis Navarro 323-329-5845
CERTIFICATION #
8171123
TEST METHOD
Annual Monitor Cert.
ICC #
APPLICANT S'I`G--N-A�TTURE DATE
THIS APPLICA ON "COMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 09/20)