HomeMy WebLinkAboutUST-APPL 1/12/2015UNDERGROUND STORAGE TANKS
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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
❑ TANK TIGHTNESS
NF..
B,Ra71
A NI' Tlfl T
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 - 326 -3979 • Fax: 661 -852 -2171
Page Iof1
❑ LINE TESTING SB -989 SECONDARY CONTAINMENT
❑ FUEL MONITORING CERTIFICATION
SITE INFORMATION
FACILIT NAME & Sri ®9dE # �3E C NTACT PEF�SiD
c 4-
ADDRESS 1 ` s o(. -Llb
OWNER NAME
CZ-W4 oie
OPERATOR NAME eO5 / A gh `ay HERMIT TO OPERATE / - # 7
d., rl kl"& 19 G'tf 15- V`�1 Kr(i C/,/'�
# OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? YES ❑ NO
TANK # VOLUME CONTENTS
07 7 ', c .�
r? 7 r-P�X 20f �90 a
1/ 1001") 1
/ _ 000
TANK TESTING COMPANY
FD2095 (Rev 03/08)