HomeMy WebLinkAbout127 BRUNDAGE Lane (3)U/13/2008 4:42:37 PM PAGE 3/005 Fax Server
BAKERSFIELD FIRE DEPARTMENT
ABOVEGROUND STORAGE TANK Prevention Services
B ( gF /RK 1501 Truxtun Ave 1ST FLR
APPLICATION FORM Dt AJtrlu if Bakersfield, CA 93301
INSTALLATION /REMOVAL OF AN AST Phone: 661 -326 -3979. Fax: 661 -852 -2171
Page 1 of 2 IIIlI�I�lulIIIIIII 27
IE
INSTALL L REMOVE
PERMIT # T I — 0".T
FACILITY NAME
CItY of Bakersfield Fire station 04
ADDRESS
12.7 Brundage Ln. Bakersfield CA •
OPERATOR NAME
Fire Station 04
PERMIT TO OPERATE #
OWNER NAME
City of Bakersfield
# OF TANKS TO BE INSTALLED 1 I REMOVED
TANK # CONTENTS VOLUME
Fire Station 04 Diesel 140 q al I o n s
Cell: 661.201.0808 Fax: 661.322,4039
doug—adams@emcorgmup.com
CA Uc. #139886
NAME OF COMPANY INSTALLING AND /OR REMOVING TANK
Contra Costa Electric
MAILING ADDRESS
3208 Landco dr. Bakersfield CA 93308
NAME & PHONE * OF CONTACT PERSON
Adams (661) 322 -4036
—Doug
DATE & TI E TANK IS TO BE INSTALLED /REMOVED
Dec mb •r 2008
SIGNATU OF APPLICAN
DATE
tl BY � �
DATE
I I I'll 111E8
FD2081 (Rev 01/08)
Contra Costa E/ecWc
An ENCOR Company
Doug Adams
Contra Costa Electric, Inc.
Pro ject Manager/
3208 Landco Drive
Estimator
Bakersfield, CA 93308
Phone: 661.322.4036 Ext.102
Cell: 661.201.0808 Fax: 661.322,4039
doug—adams@emcorgmup.com
CA Uc. #139886
www.ccelectric.com