HomeMy WebLinkAboutAST Application 6-6-22ABOVEGROUND STORAGE TANK
APPLICATION FORM 'b�
INSTALLATION/REMOVAL OF AN AST �►
INSTALL REMOVE
PERMIT #
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 • Fax: 661-852-2171
Page 1 of 2
FACILITY NAME
Station 202
ADDRESS
3608 Brisbane Ave, Bakersfield CA 93313
OPERATOR NAME
California Water Services Co.
PERMIT TO OPERATE #
OWNER NAME
California Water Services Co.
# OF TANKS TO BE INSTALLED _ / REMOVED
TANK # CONTENTS VOLUME
1 Diesel No. 2 620 Gallon
NAME OF COMPANY INSTALLING AND/OR REMOVING TANK
MAILING ADDRESS
NAME & PHONE # OF CONTACT oF-pcnni
DATE & TIME TANK IS TO BE INSTALLED/REMOVED
10/15/2021
SIGNATURE OF APPLICANT r--.,
DATE
1/11/2021
APPROVED BY
DATE
FD2081 ;Rev 02/17)