HomeMy WebLinkAboutFMC Permit App 12-23-15UNDERGROUND 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 #
FIRE
wirer
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
Q 10 L k-k 5 -mev.7
Bakersfield, CA 93301
Phone: 661 -326 -3979 • Fax: 661 -852 -2171
Page 1 of 1
❑ ENHANCED LEAK DETECTION ❑ LINE TES ❑ SB -989 SECONDARY CONTAINMENT
❑ TANK TIGHTNESS F L MONITORING CERTIFICA17I N
SITE INFORMATAQN .
FACILITY -T— NAME & PHONE # OF CONTACT PERSON
ADDRESS coo
OWNER NAME
OPERATOR NAME
# OF TANKS TO BE TESTED:
TANK #
J
PERMIT TO OPERATE #
IS PIPING GOING TO BE TESTED?
VOLUME
❑ YES ❑ NO
CONTENTS
0
FD2095 (Rev 03/08)