HomeMy WebLinkAboutAST Install Permit App 11-15-16ABOVEGROUND STORAGE TANK
APPLICATION FORM g E FIRE
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INSTALLATION /REMOVAL OF AN AST ARfA!
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PERMIT # O ,-,7.
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661- 326 -3979 • Fax: 661- 852 -2171
Page 1 of 2
FACILITY NAME
Ming and Gosford AT &T Cell Tower Site
ADDRESS
8201 Camino Media, Bakersfield, CA 93311
OPERATOR NAME
New Cingular Wireless PCS, LLC dba AT &T Mobility
PERMIT TO OPERATE #
OWNER NAME
New Cingular Wireless PCS, LLC dba AT &T Mobility
NUMBER OF TANKS TO BE INSTALLED /REMOVED
TANK # CONTENTS VOLUME
1 Diesel 190 Gallons
NAME OF COMPANY INSTALLING AND /OR REMOVING TANK
General Dynamics Wireless Services
MAILING ADDRESS
6664 S. Dateland, Suite B, Tempe, AZ 85283
NAME & PHONE # OF CONTACT PERSON
Mark Roter (480) 296 -7473
DATE & TIME TANK IS TO BE INSTALLED /REMOVED*
July 2016
SIGNATURE OF PLI ANT
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DATE
APPROVED BY
DATE
FD2081 (Rev 12/2015)
Fire Plans Examiner Ernie Medina states that if an exact date /time of installation is not yet determined, then the month and year is sufficient.