HomeMy WebLinkAboutFMC APP 12.19.18UNDERGROUND 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 /
FACILITY
ADDRESS
OWNER NAME
OPERATOR NAME
# OF TANKS TO BE TESTED:
TANK *
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 -326 -3979 • Fax: 661 -852 -2171
Page 1of1
FUEL MONITORING CERTIFICATION VERFILL PREVEN 11
E. YNOORMATIO
NAME & PHONE # OF CONTACT PERSON
IPERMIT TO OPERATE #
IS PIPING GOING TO BE TESTED?
VOLUME
TAKK TESTING COMPANY
NTAINMENT
0 YES ❑ NO
CONTENTS
—
IS APPLICATION BECOMES A PERMIT WHEN APPROVED
DATE
APPROVED BY
FD2095 (Rev 03/18)