HomeMy WebLinkAboutCATH APP 4.1.19APPLICATION
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 #
BA ERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 -326 -3979 o Fax: 661 -852 -2171
Page 1 of 1
❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT
❑ FUEL MONITORING CERTIFICATION ❑ OVERFILL PREVENTION
FACILITY "? NF, E & PHO !E # o INTAC PER ON
alit Pt;ft- -
ADDRESS 4 F
OWNER NAME (';
OPERATOR NAMEJ PERMIT TO OPERATE #
# OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK # VOLUME CONTENTS
/D ®® kc)
1;- _ 10
FD2095 (Rev 03/18)