HomeMy WebLinkAboutFMC APP 12.11.19UNDERGROUND STORAGE TANKS
IS PI-r'ING GOING TO BE TESTED? ❑ YES ❑ NO
®ry
rA;RJ
CONTENTS
ArPiacATi
r
TO PERFORM ELD /LINE TESTING/
SB999 SECONDARY CONTAINMENT
TESTING/TANK TIGHTNESS TEST AND
DEL MONITORING CERTIFICATION
( Piease note that these are separate
individual tests and will he charged per
geparats type zest accordingly.)
PERMIT'*
F-7—=
❑ ENHANCED LEAK DETECTION U LINETESRNC;`- -.
❑ TANK TIGHTNESS FFIJEL MONITORING
TACIL
ADDRESS
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
atot Ft 5iREE7
Bakersfield, CA 93301
Phone: 661 - 326 -3979. Fax: 661 - 852 -2171
Page 1 of 1
❑ SB -989 SECONDARY CONTAINMENT
PERSON
> OF TANKS TO eE TESTED:
IS PI-r'ING GOING TO BE TESTED? ❑ YES ❑ NO
TAIK ,°.
VOLUME
CONTENTS
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i
TANK ICm tnV —1--
TESTING COMPANY NAME & PHONE .°. OF CONTACT PERSON
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MAILING ADDRESS
i �t.¢� -13 t�AooK -S �T. - �hKE- �F2.SFtEL -D.CK °330&
NAME &PHONE F TEETER OR SPEC AL INS R — CERTIFICATIONA
T
: pATE &TIME TEST TO BE CONDUCTED TEST METHOD
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APPLICANT SIG RE _ DATE / /
'l1 /I �lll�3
li /,4HIS APPLICATION BECOMES A PERMIT WHEN APPROVED
DATE
AvP0.0VED BY
FD2095 (Rev 03/08)