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HomeMy WebLinkAboutOPI Application 12-9-22UNDERGROUND 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 ❑ LINE TESTING ❑ TANK TIGHTNESS ❑ RJEL MONITORING CERTIFICATION 50V%W%16 wr-iW.16v W -&■%16 v16rh5% s M161'% s Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: •661-852-2171 Page 1of1 58-989 SECONDARY CONTAINMENT OVERFILL PREVENTION 51 INFORMATION FACILITYNAME & PHONE 4 OF CONTACT PERSON ko Uc)�— ADDRESS t l 1 / 1 /, c D OWNER NAME OPERATOR NAME PERMIT TO OPERATE � OIL (NC TdhfYC T/'t QC TCCTC!11. Tt- f1Tl1TlLlr- TANK TESTING ACOMPAIdY TESTING COMP NAME & PHONE # OF CONTACT RS N MAILING ADDRESS 1 IF), Rnn VS C -IT 0 T:Z�F V -r LY) . r A R /C)/5/zz, if THIS APPt3CATION BECOMES A PS MIT WHEN APPROVED FD2095 (Rev 09/20)