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6630 ROSEDALE Hwy_UST
I" �.r�+•dnr.Mfl � Jh.ti- yam„- f�1yJV�yy .,'••'tM.•+r4- Y^' ✓'^f4�11 - �: Bakersfield Fire Dept. �►�B�ILLING & PERMIT STATEMENT PREVENTION SERVICES Pyre Safety Services • Environmental. Services 1715 Chester Ave Bakersfield, CA 93301 ' Tel: (661)326 -3979 DATE US IAST MIT, TANK TESTING •Ii1'%^ OW TENTS, LPG, FIREWORKS, POWDER/OTHER PERMITS FOLLOW -UP INSPECTION $2 .STATE SURCHARGE I� IIIIIIIIIIIIIIIIIIII 67 I 86 84 COPIES/REPORTS IE - -� 89 . INSPECTOR: DATE TIME SPENT: CHARGES: CHARGES CODE: REASON and DATE FOR INSPECTION: LOCATION OF INSPECTION: BUSINESS NAME: TELEPHONE NUMBER(S): BILL.TO: PAY BY: sed ct.QQ 4w NOTES: OS-3 L4 . — R • CUSTOMER SIGNATURE: IIIIIIIIIIIIIIIIIIII 68 : • INSPECTORIR /ECEII/ R SIGNAT9R . ORIGINAL WHITE: FINANCE ' . CUSTOMER: PINK OFFICE: YELLOW; ..- " . FD1 734 (rev. 12/03) :h ._.....- ;'A._.�a: A ..7'