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 note that these are separate
individual tests and will be charged per
separate type test accordingly.)
PERMIT #
❑ ENHANCED LEAK DETECTION
❑ TANK TIGHTNESS
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 • Fax: 661-852-2171
Page 1of1
❑ LINE TESTING CONTAINMENT
❑ FUEL MONITORING CERTIFICATIONP5%'OVERFILL PREVENTION
SITE INFORMATION
FACILITY NAME & PHONE # OF CONTACT PERSON
DU
ADDRESS 1
OWNER NAME
OPERATOR NAME —j PERMIT TO OPERATE #
OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO
TANK#
VOLUME CONTENTS_ rj
1
C
1
3 I
1
i
i
TANK TESTING COMPANY
TESTING COMPr> NAME & PHONE # OF CONTACT P RS N
t -
c 1vt1�S� ��-. $tom
MAILING ADDRESS
�SU47S
NA713 E # TESTER O SPE IA INSPECTOR CERTIFICATION #
IR C9 Is 'So
TEST METHOD ICtuj�?'C-
# w
s
APPLICANT SI TURE DATE
-411 2.,2
_ 1
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY DATE
FD2095 (Rev 09/20)
02