HomeMy WebLinkAboutAST APPLICATION 11/14/2007® INSTALL REMOVE
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BAKERSFIELD FIRE DEPARTMENT
Prevention Services
1600 Truxtun Ave., Suite 401
Bakersfield, CA 93301
Phone: 661 - 326 -3979 • Fax: 661- 852 -2171
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ADDRESS tJ�/I.
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# OF TANKS TO BE INSTALLED If / REMOVED CU
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NAME OF COMPANY INSTALLING AND /OR REMOVING TANK
MAILING ADDRESS
NAME & PHONE # OF CONTACT PERSON
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DATE & TIME TANK IS TO BE INSTALLED /REMOVED
SIGNATURE OF PP ICANT
DATE
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FD2081 (Rev 08/07)