HomeMy WebLinkAboutSB-989 Permit Application 2008UNDERGROUND STORAGE TANKS
Y
APPLICATION
TO PERFORM ELD /LINE TESTING/
SB989 SECONDARY CONTAINMENT
TESTING /TANK TIGHTNESS TEST AND
FUEL MONITORING CERTIFICATION
PERMIT # -::' =?j
ENHANCED LEAK DETECTION
TANK TIGHTNESS
69A1
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LINE TESTING
FUEL MONITORING CERTIFICATION
SB -989 SECONDARY CONTAINMENT
SITE INFORMATION
BAKERSFIELD FIRE DEPARTMENT
A Prevention Services
OWNER NAME
1600 Truxtun Ave., Suite 401
FIRS Bakersfield, CA 93301
ARTN' T Phone: 661 - 326 -3979 a Fax: 661 - 852 -2171
VOLUME
Page 1 of 1
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LINE TESTING
FUEL MONITORING CERTIFICATION
SB -989 SECONDARY CONTAINMENT
SITE INFORMATION
FACILITY NAME & PHONE # OF ONTACT PERSON
ADDRESS q76LO Q.Q gf ICET25 lELD, C 4 3j,
OWNER NAME
OPERATOR NAME + PERMIT TO OPERATE # _
OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? YES NO
TANK # VOLUME CONTENTS
TANK TESTING COMPANY
TESTING COMPANY NAh} &PHONE # OF CONTACT P RSON /J f ,. - X
J
MAILING ADDRESS /
30
NAME & P NE # OF TESTER OR SSPJECIAL INSPECTOR CERTIFICATII,O_N # ^ ^ '
Ca' D-
DATE & TIME TEST TO DE CONDUCTED ICC # TEST METHOD
APPLICANT SMAT/i
JZ
DATE
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
OV D BY DATE
11-26-63'
4• N 5&cr 1211916s- FD2095 (Rev 06/07)