HomeMy WebLinkAboutCOLD START Application 5-17-22UNDERGROUND 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
N
❑ LINE TESTING
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
Lucky 7
NAME & PHONE # OF CONTACT PERSON
ADDRESS
726 S. Union Bakersfield, 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
test sensors after TLS uprade
TANK TESTING COMPANY
TESTING COMPANY
BSSR, Inc.
NAME & PHONE # OF CONTACT PERSON
Kelly Tackett 688-2777
MAILING ADDRESS
6630 Rosedale Hwy #B Bakersfield, CA 93308
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Nathan Holman
CERTIFICATION #
B40744
TEST METHOD
ICC #
8111067
APPLICANT IGNATURE DATE
4-18-22
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 09/20)