HomeMy WebLinkAboutUST-APPLICATION 7/8/2015UNDERGROUND 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 #
❑ ENHANCED LEAK DETECTION
CJ TANK TIGHTNESS
# OF TANKS TO BE TESTED:
TANK #
J /R/
Aar�r r
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
alo c k-k 5TXR-V -E-T"
Bakersfield, CA 93301
Phone: 661 -326 -3979 • Fax: 661- 852 -2171
Page 1 of 1
®LINE TESTING SB -989 SECONDARY CONTAINMENT
❑ FUEL MONITORING CERTIFICATION
SATE �t�r- oA�ri�N
NAME &. PHONE # OF CONTACT PERSON
r)vh
PERMIT TO OPERATE #
IS PIPING GOING TO BE TESTED?
VOLUME
Y�'NK'�'EST7[!�� Cf3�!lis/kN`9f
❑ YES ❑ NO
CONTENTS
APPROVED BY
7'HIc.�;;APPL.ICATION BECOMES A PERMIT WHEN APPROVED
DATE
N
FD2095 (Rev 03/08)