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PROPANE EXCHANGE STORAGE TANK(S) i
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APPLICATION H BP/R! I p
FOR INSTALLATION /REMOVAL OF ~ ' ARTIII/ f
PROPANE EXCHANGE TANK(S) ~
~' INSTALL ^ REMOVE
PERMIT: #. ~ ~ -- ~ l
BAKERSFIELD FIRE DEPT.
Prevention Services
1600 Truxtun Ave., Ste. 401
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
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FACILITY .
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ADDRESS
OPERATORS NAME
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OWNERS NAME
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NUMBER OF CAGES TO BE INSTALLED ~ /REMOVED
TOTAL NO. OF TANKS
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NAME OF COMPANY INSTALLING 8 / OR REMOVING TANK(S)
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MAILING ADDRESS ._
NAME 8~ PHONE NUMBER OF CONTACT RSON
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DATE 8 TIME T E INSTALLED OR REMOVED
SI TURE OF AP LICANT ~.~C.J~ DATE C
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APPROVED BY DATE
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FD 2115 (Rev. os/o5)