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HomeMy WebLinkAboutFUEL MON CERT 12/22/2004 13:54 6613920621 PAGE 01/01 -COpy REQUESTED PLEASE FAX(661}392-0621 CITY OF BAKERSFIELD OFFICE"OF ENVIRONMENTAL SERVICES ·l100 TRLV\1ún ~.-~'R~rf.Ð-b,CJ'i 'ff1.x (LPl.oQeg5~-õHï·\ . APPLICATION TO PERFORM FUEL MONITORING CERTIFICATION FAClllTY +:""- 2 ~ TrJ¡O 'T :=RSN~\ j::.TH 51, - ßl'\-k¡=J2.-;:;:rIF~IC~"1~õ08' OWNERS NAME \~. cJtO"'O- ' NAMEOFMONlTORMANUFACTURER . \JJ2~ Røro-:T ~S:3 S" ð DOESFAcn..rrYHAVEDISPENSERPANS1 YES"><" NO_ TANK * \ -2. '"? VOLUME to , DOO /J)JrxYJ ~O(')ð CONTENTS unL- 'if ì ~lCm,,:,£} I ñ I~Sf21 NAMEOFTBSTlNG COMPANY }UCH Et{YIRONMENTð,L cON'tRACTO~ UCENSE, 90-1072 NAME &. PHONE NUMBER OF CONTACT PERSON JAMES RICH DATE & TIME TEST IS TO BE CONDUCfED .:;1 .¡ ¡} .\v,t; 'J (ælß1JJt/r{) APPROVED BY lJ-ì.?-{)c/ DATE , ~li ;11 ('C-.. ' DNATUREOFAPPUCANT --