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Home My WebLink AboutApplication 3-16-22UNDERGROUND 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 # I I ❑ ENHANCED LEAK DETECTION ❑ TANK TIGHTNESS FACILITY ADDRESS BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 Page 1 of 1 ❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT FUEL MONITORING CERTIFICA ON ❑ OVERFILL PREVENTION SITE I11lFORMATIO NAME & PHONE ## OF CONTACT PERSON TANK TESTING COMPANY ❑ YES ❑ NO CONTENTS ---- ---- ----- --- - ESTING COMPA I NAME & PHONE # C3E CONTACT PER53N, MVI�Ro A 4aA �Ak-E- �&CCAk m MAILING ADDRESS Q tan tzcv) NAME & PHONE # T T P IA INSP TOR ` CERTIFICATION # ISO — -- � - - — TEST METHOD ICC J 75'?-,`� 7- APPLICAN RE �DATE i � f THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FD2095 (Rev 09/20) (i Vvi 0) OPERATOR NAME PERMIT TO OPERATE # # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? _ TANK# VOLUME r 00 TANK TESTING COMPANY ❑ YES ❑ NO CONTENTS ---- ---- ----- --- - ESTING COMPA I NAME & PHONE # C3E CONTACT PER53N, MVI�Ro A 4aA �Ak-E- �&CCAk m MAILING ADDRESS Q tan tzcv) NAME & PHONE # T T P IA INSP TOR ` CERTIFICATION # ISO — -- � - - — TEST METHOD ICC J 75'?-,`� 7- APPLICAN RE �DATE i � f THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FD2095 (Rev 09/20)