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HomeMy WebLinkAbout11-15 UST APPLICATIONUNDERGROUND 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 BAKERSFIELD FIRE DEPARTMENT ❑ LINE TESTING ]I SB -989 SECONDARY CONTAINMENT ❑ FUEL MONITORING CERTIFICATION SITE INFORMATION FACILITY NAME 8c PHONE # OF CONTACT PERSON FIESTA LIQUOR ADDRESS C 2023 BAKER ST OWNER. NAME 1&t� OPERATOR NAME PERMIT TO OPERATE # # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? (A YES © NO TANK # VOLUME CONTENTS 1 12,000 PREMIUM 2 12,000 UNLEADED 3 12,000 PLUS ,t..L ��, -�1, 11 -5 -15 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY --7;7 1 DATE FD2095 (Rev 03/08)