HomeMy WebLinkAboutSB 989 Permit 3-31-22UNDERGROUND STORAGE TANKS
4L
APPLICATION
TO PERFORM ELD/LINE TESTING/
SB989 SECONDARY CONTAINMENT
TESTING/TANK TIGHTNESS TEST AND
FUEL MONITORING CERTIFICATION
I'P"ease note that these are separate
Orldividual tests and will be charged per
separate type test accordingly.)
PERMIT # I I
E] ENHANCED LEAK DETECTION
0 TANK TIGHTNESS
FACILITY
ADDRESS Lk
OWNER NAME
OPERATOR NAME
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 * Fax: 661-852-2171
Page 1 of 1
NE TESTING 101'
JEL MONITORING CERTIFICATION
SITE INFORMATION
NAME PHONE F CONT
OF TANKS TO BE TESTED: is P
T A N K #
. ... ......
TANK TESTING COMPANY
TESTING COMPA NAME & PHONE 4 OF CONTACT PERS N
1 .-uA �A k �Ac_CAk
MAILING ADDRESS
Lo q
i CERTIFICATION #
NAME NE F E I R
NE R%E%13n�ll
T4 D ICC
TEST METH D
A LLICANT SI ATU DATE
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
5 {9$9 SECONDARY CONTAINMENT
VERFILL PREVENTION
T PERSON
L
PERMIT TO OPERATE
)ING GOING TO BE TESTED? 0 YES 0 No
VOLUME I CONTENTS
APPROVED BY
FD2095 (Rev 09/20)