HomeMy WebLinkAboutOPI Application10-14-22UNDERGROUND 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
❑ TANK TIGHTNESS ❑ FUEL MONITORING CERTIFICATION
FACILITY
ADDRESS
OWNER NAME
OPERATOR NAME
# OF TANKS TO BE TESTED:
TANK#
-3
SITE INFORMATION
9 SECONDARY CONTAINMENT
=ILL PREVENTION
NAME & PHONE # OF CONTACT PERSON
PERMIT TO OPERATE #
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IS PIPING GOING TO BE TESTED?
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❑ YES
CONTENTS
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NAME & PHO # F hSTER O SPE I I SPE CERTIFICATION
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AP ANT SI ATURE DATE
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THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY I DATE
FD2095 (Rev 09/20)