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HomeMy WebLinkAboutUNDERGROUND STORAGE TANK -,, .' r9 (UNDERGROUND STORAGE TANKS) FILE # -' ~ STOCKDALE CHEVRON _____ _ ~ 13004 STOCKDALE HWY. ~ _ . _ _ T _ - 'I~ / R u` i. - l~ `.i'~~ ~, .~ •.. ~ ~ ~~ '"~ UNDERGROUND STORAGE TANKS APPLICATION. TO PERFORM ELD /LINE TESTING / S6989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION BAKERSFIELI) FIRE DEPT. R s ~ ~ D Prevention Services e~~~e ARTM T 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 PERMIT NO. ~ ~ r" ©ZS ^ ENHF~NCED LEAK DETECTION ^ LINE TESTING ~ SB-989 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST ^ TO PERFORM FUEL MONITORING CERTIFICATION - 51ItiNt,U HMHIIVN FACILITY NAME & PHONE NUMBER OF CONTACT PERSON DDRESS 13 b b , a.le.~; WNERS NA PERATORS NAME PERMIT TO OPERATE NO. I UMBER OF TANKS TO BE TESTED IS PIPIN G GOING TO BE TESTED? YES ^ NO TANK# VOLUME CONTENTS NAM OF TESTING COMPANY I TANK TESTING COMPANY ~ NAME & PHONE NUMBER OF CONTACT PERSON 3~ -c~9R AILING ADD E5S ,P.a. iS~ CA g33oa AM & PHONE NUMBER OF ESTER ORS CIAL SPECTOR 1- 39~- ~ ERTIFICATION #: - 0~''©3~''~~9--eSb3S)3~- DATE TIME TEST TO BE CONDUCTED -o oZoo~ - ; bo ~°~ CC #: Sa X19 a~ (,-- UT EST METHOD GNATURE OF PLICANT ATE I-a -o ~~~. ~i ~ ~~.~~ - R ~ ~ ~ Q ~ PPROVEDBY r .- _ _ ___ ATE/ ~S I FD2106 Bakersfield Fire Dept. PREVENTION"SERVICES :.Eire Safety Services • Environmental Services 900 Truxtun Ave:, Suite 210 Bakersfield, CA 93301 Tel: (661) 326-3979 C ... USTlAST PERMIT, TANK TESTING tf~_ 82 STATE SURCHARGE B6 ~' (:.,T TENTS: LPG,.FIREWORKSrPOWDER/OTNER PERMITS 84 COPIES/REPORTS 89 FOLLOW=UP INSPECTION INSPECTOR:.: DATE TIME SPENT:. CHARGES: CHARGES CODE:. REASON and GATE ~ f ~'.-•""'" FOR INSPECTION: LOCATION OF INSPECTION: +' t BUSINESS-NAME . j~ TELEPHONE NUMBER(S): i~ ~~ ~ BILL TO: ~ ,} . PAY BY: , ~~ ( ~ ~::a ''"'-- NoTi=s: .~ ~ IS CUSTOMER SIGNATURE: INSPECTORIRECENER SIGNA7U : ~n , s~~ T ORIGINAL'NMRE FINANCE CUSTOMER-PINK OFFICE: YELLOW: FD1734(feY• 1?JU3)