HomeMy WebLinkAboutOPI Application 5-23-22UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD/LINE TESTING/
SB989 SECONDARY CONTAINMENT
TESTING/TANK TIGHTNESS TEST AND
FUEL MONITORING CERTIFICATION
(please nate that these are separate
individual tests and will be charged per
separate type test accordingly.)
PERMIT #
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 • Fax: 661-852-2171
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❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ SB -989 ARY CONTAINMENT
❑ TANK TIGHTNESS ❑ FUEL MONITORING CERTIFICA ON OVERFILL PREVENTI
SITE I MATION
FACILITY AME & PHONE # OF CONTACT PERSON
ADDRESS
OWNER NAME
OPERATOR NAME
--- -
PERMIT TO OPERATE #
i
# OF TANKS TO BE TESTED:
IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
T A N K #
VOLUME CONTENTS'
i
I
TANK TESTING COMPANY
TESTING COMPAJNk '; NAME & PHONE # OF CONTACT P RS N
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MAILING ADDRESS
CIT 1=1 i�3011R
NAME & P ON # OF ESTER OR JECIA I + CERTIFICATION # Q
TEST METHOD A \1 \ n In n 1 1 / 1 ICC
APPLILTSIGNATUR I DATE
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY I DATE
FD2095 (Rev 09/20)
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