HomeMy WebLinkAboutPERMIT APPLICATION-9, to T
IT ffW=
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
---�TA R�HTN E SS i
FACILITY tf%
MCAX
ADDRESS
OWNER. NAME
OPERATOR NAME
# OF TANKS TO BE TESTED:
TANK. #
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
11 1
j -r a-S
rlR;. AN Bakersfield, CA 93301
R TIV T
TM, T Phone: 661-326-3979 * Fax: 661-852-2171
Page 1 of I
❑ LINE TESTING ❑ SB-989 SECONDARY CONTAINMENT
❑ FUEL MONITORING CERTIFICATION
SITE 0
It. A
I I NAME &PHOf4A'09COfjTACT PERSON
PERMIT TO OPERATE #
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
VOLUME CONTENTS
X—Z-
FD2095 (Rev 03/08)