HomeMy WebLinkAboutAST APPLICATION 5/28/2005INSTALL E REMOVE
PERMIT # J—° 06-4�
b
4
�N%L � B ERS
FIRS
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
1501 Truxtun Ave 1ST FLR
Bakersfield, CA 93301
Phone: 661- 326 -3979 • Fax: 661- 852 -2171
Page 1 of 2
FACILITY NAME 6 d X' C'
ADDRESS
leclek
OPERATOR NAME
PERMIT TO OPERATE #
OWNER NAME ® f _
# OF TANKS TO BE INSTALLED `� / REMOVED _0
TANK # CONTENTS VOLUME
® �✓ G /�'(e i �= �. I C-2 C2 C:) dc:-'
5-G
NAME OF COMPANY INSTALLING AND /OORR REMOVING TANK
MAILING ADDRESS
10� cr erZS .0C-it::�1.,
NAME & PHONE # OF CONTACT PERSON
DATE & TIME TANK IS TO BE INSTALLED/ REMOVED
1pe- JPC % e' T? t" I
SIGNATURE OF APPLICANT
DATE _
A PROVE BY
L
DATE
.6111107
FD2081 (Rev 01/08)