Loading...
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 Page Iof1 ❑ 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)