HomeMy WebLinkAboutFMC application 6-13-22_4-9Ll
UNDERGROUND STORAGE TANKS
Q
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 # j j
❑ 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 1of1
❑ SB -989 SECONDARY CONTAINMENT
❑ OVERFILL PREVENTION
SITE INFORMATION
FACILITY
Mesa Marin Chevron
NAME & PHONE # OF CONTACT PERSON
Mohammod Muthana 661-366-4886
ADDRESS
11101 Hwy 178, Bakersfield
OWNER NAME
Muthana Corp.
OPERATOR NAME PERMIT TO OPERATE #
Mohammod Muthana
# OF TANKS TO BE TESTED: 3 IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
T A N K #
VOLUME
CONTENTS
1
2
12000
12000
87 UNL
91 U N L
3
12000
DSL
TANK TESTING COMPANY
TESTING COMPANY
Nwestco LLC
NAME & PHONE # OF CONTACT PERSON
Karli Karns 661-631-3870
MAILING ADDRESS
2209 Zeus Court, Bakersfield, CA 93308
NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR
Ron Clark 661-525-3825
CERTIFICATION #
TEST METHOD
ICC #
9482314
PPLICANT SIGNATURE
-
DATE
05/10/22
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY
DATE
FD2095 (Rev 09/20)