Loading...
HomeMy WebLinkAboutSB989 APP 11.15.19UNDERGROUND 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 # D ❑ ENHANCED LEAK DETECTION ❑ TANKTIGHTNESS Ih•�"Ny BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661 - 326 -3979 • Fax: 661 - 852 -2171 Page 1 of 1 AA iz)VA" ❑ LINE TESTING IVSB -989 SECONDARY CONTAINMENT ❑ FUEL MONITORING CERTIFICATION ❑ OVERFILL PREVENTION FD2095 (Rev 03/19) SITE INFORMATION FACILItt + ^ D� L D PHON N OF CONTACT PERSON IlS 1111E56 DWNER MEY LL ��F�`^ OPERATOR NAME M1 PERMITTO OPERATE #� # OF TANKS TO BE TESTED: I5 PIPING GOING TO BE TESTED? X YES ❑ NO TANK # VOLUME CONTENTS loK Elm 8 + TANK TESTING COMPANY TESTIN COMPANY �( AME .E Z CR T PERSON MAILING ADD_Y W 1& 1 ON # ER O SPECIAL INSPECTOR S CERTIFICATWN # TEST METHOD �'J 11 ECCN 52—SZ.JW Ltt�JL ^� L qPP NT SIGNATURE OgiE . LQ . THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE FD2095 (Rev 03/19)