HomeMy WebLinkAbout5609 STINE RD SB989 APP 9.15.14UNDERGROUND STORAGE TANKS BAKERSFIELD FIRE DEPARTMENT
Prevention Services
EA $ F
k--k
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APPLICATION rA;JRjTm, r Bakerstield, CA 93301
TO PERFORM ELD/LINE TESTING/ Ah- Phone: 661-326-3979 • Fax: 661-852-2171
SB989 SECONDARY CONTAINMENT
TESTING/TANK TIGHTNESS TEST AND Page I of I
FUEL MONITORING CERTIFICATION
(Please note that these are separate
individual tests and will be charged per
separate type test accordingly.)
PERMIT #
❑ ENHANCED LEAK DETECTION ❑ LINE TESTING (]jB:-98:9 SECONDARY CONTAINME
❑ TANK TIGHTNESS ❑ FUEL MONITORING CERTIFICATION
SITE INFORMATION
FACILITY NAME & PHONE OF CONTACT PERSON
ADDRESS I ccnc�
OWNER NAME
OPERATOR NAME I PERMIT TO OPERATE #
# OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK # VOLUME CONTENTS
FD2095 (Rev 03/08)