HomeMy WebLinkAboutAST APPLICATION 10/16/2008_+._iil3/2008 4:57:36 PM PAGE 5/005 Fax Server
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BAKERSFIELD FIRE DEPARTMENT
ABOVEGROUND STORAGE TANK ~:: ~y"'~~--~=-- Prevention Services
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APPLICATION FORM ~ t"; a3~-'AAIM~'~t'r sakersfield, CA 93301
INSTALLATION/REMOVAL OF AN AST ~' ~~~ Phone: 661-326-3979 ? Fax: 661-852-2171
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10/13/2008 4:57:36 PM PAGE 5/005 Fax Server
Prevention Services
ABOVEGROUND STORAGE TANK --:-
7., 1501 Tri ixtun Ave 1sT FLR,
FIRE
APPLICATION FORM Bakersfield, CA 93301
0S ARyMjrjVr
INSTALLATION/REMOVAL OF AN AST Phone: 661-326-3979 Fax: 661-852-2171
Page 1 of 2
NINSTALL. E] REMOVE
PERMIT # 1�5,401
FACILITY NAME
CO/Y97-/ZLACII-��(-)/v 7 4�
ADDRESS
1,;L,!a0b SNOw c7-33� Y
OPERATOR NAME
PERMITTO OPERATE
OWNER NAME
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*OF TANKS TOSEINSTALLED I RiEPAM\-
TANK CONTENTS VOLUME
NAME OF COMPANY INSTALLING AND /OR REMOVING TANK
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MAIL ADDRESS
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NAME & PHONE 4.' OF CONTACT PERSON
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DATE & TIME TANK fS TO SE INSTALLED REMOVED
SIGNPURE OF APPLICANT
DATE
APPROVED BY
DATE
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