HomeMy WebLinkAboutSB989 APP 12-3-18UNDERGROUND 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
❑ TANK TIGHTNESS
B B R 3 F I D
FLEA!
A R Tm',A T
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
0110t k-k s .IF--V7
Bakerstield, CA 93301
Phone: 661 - 326 -3979 • Fax: 661 -852 -2171
Page 1 of 1
❑ LINE TESTING =SECONDARY
❑ FUEL MONITORING CERTIFICATION
SITE INFORMATION
FACILITY t NAME & PHONE # OF CONTACT EMERSON
ADDRESS
�±
OWNER NAME
OPERATOR NAME
PERMIT TO OPERATE #
# OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK # VOLUME CONTENTS
:L
TANK TESTING COMPANY
TESTING COMPANY NAME & PHONE # OF CONTACT PERSON
MAILING ADDRESS 5U LA
NAME & P E # OF #STER OR SPE AL I SPECTOR CERTIFICATION #
o Aji-A fin ,[) 01a
FD2095 (Rev 03/08)