HomeMy WebLinkAboutOPI Application 10-28-22UNDERGRO-W-u E TA�
APPLICATION
TO PERFORM a D/UNE TES; H4C-/
58989 SECONDARY CONTAINMENT
'TES I NG/TANK TIGH MESS TES I AND
FUEL MONITORING CERTIFICATION
(Please note that these are separate
individual tests and will be charged per
separate type test accordingly.)
PBtMIT #
D EMAME EAE DETEC I D LINE TES I
D TANK I MWESS FUEL MONITORING Thi
�
RS LD FIM KNWARTNFJff
2101 H Street
Bar C# 93341
Phone: 661-326-3979 • Fax: 661-852-2171
Page 1 of 1
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7 AM 50
NAME & PHONE # OF CONTACT PERSON
(WI)
ADDRESS
74ELEVEN 422'150,4012 WHITE LN, BAKERSFRELD, KERK CA 93309
oVONER NAME
74 LEVEN 5150
OPERAFoR NWME
74ELEVEN 8.M50
FERIWTo ORATE #
OF TANKS TO BE TESTED:
IS PWBSG GING TO BE TESTED? D YES D NCI
TANK*
VOLUNE
CONTENTS
T1
20K
REG Unleaded
T2
8K
Premium
T
'12K
Diesel
TAM TESIBW CO
'iPSTIIrG COSY
Tank- bgYILftk
NAME & PHONE # OF CONTACT PERSON
L se 951-676-4060
NABJW AEC ESS
41785 Enterprise Cide South AD
NMNE R ftKWE * Of -IESI R OR sPEawL BWW10R
L:as
CMA NAM
8171123
TEST PIEMOD
overm I-1,- OF lion
ICC #
8171123
APPUWAW sa AIUME
DANE
TH LICA ON"MESA PERN 1A/ EiM APPROVED
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