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12/15/2004 10:35 6613252529
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PAGE 02
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester A ve.~ Bakersfield, CA (661) 326-3979
APPLICA TION TO PERFORM
FUEL MONITORING CERTIFICATION
FACILITY Pd.-Vii.! 0/1...
ADDRESS 7ø3t.1 ScJlI'VV4 c.,r ßAk-er.s"¡;'t'J~ç Cö...
OPERATORS NAME PA.·!//~S OiL
OWNERS NAME S~"",.e.
NAME OF MONITOR MANUFAcr~~t(-eY'-Roo1-
DOES FAcn..rry HA VB DISPENSER PANS? YES V
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TANK #
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VOLUME
CONTENTS
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NAME OF TESTING COMPANY Ca. /- VtIL! /-c~ Ef'&.i..1 ~JHb1'"
CONTRACTORSUCENSB# 7fšt¡/7fJ A fl.Az
NAME &. PHONE NUMBER OF CONTACT PERSON l5Yuc~ Mhs'/;:t (ð~/-:327-6fJ¥/
DATE & 'I'IMS TEST IS TO BE CONDUCTHt> [2--30-0'1 f!2 13 ~oo
APPROVED BY
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SIGNATURE OF APPUCANT