HomeMy WebLinkAboutUST APPBAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 • Fax: 661-852-2171
Page I of 1
TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY ❑ NEW TANK INSTALL/EXISTING FACILITY
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STARTING DATE/ 04/28/2014 PROPOSED
COMPLETION DATE OS/02/2014
FACILITY NAME Fastrip #6 7
EXISTING FACILITY PERMIT #
FACILITY ADDRESS
1640 South Chester Avenue
CITY Bakersfield
ZIP CODE 93304
TYPE OF BUSINESS GDF
APN #
TANK OWNER Jaco Hill
PHONE # (6 61) 393-7000
ADDRESS
PO Box 82515
CITY
Bakersfield
ZIP CODE
93380-2515
CONTRACTOR
Confidence UST Services, Inc.
CA LICENSE #
804904
ICC #
8018524-Ul
ADDRESS
16250 Meacham Road
CITY
Bakersfield
ZIP CODE
93314
PHONE #
(661) 631-3870 1
BAKERSFIELD CITY BUSINESS LICENSE #
32864
WORKMANS COMP #
1308371-2013
INSURER
State Fund
BRIEFLY DESCRIBE THE WORK TO BE DONE: Excavate in front of each UDC to install Bravo
Penetrations and test boots. Install Bravo Penetrations on all entry
points STP sumps. Excavate and expose 4 STP sumps. Minor piping
modifications.
WATER TO FACILITY PROVIDED BY
DEPTH TO GROUND WATER
SOIL TYPE EXPECTED AT SITE
# OF TANKS TO BE INSTALLED
ARE THEY FOR MOTOR FUEL?
� ❑ YES 1:3 NO
SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
❑ YES ❑ NO
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
TANK #
VOLUME
UNLEADED
REGULAR
PREMIUM
DIESEL
OTHER
1
12000 gal.
X
X
2
12000 gal.
X
3
12000 gal.
X
X
4
12000 gal.
—
X
Tank Testing Company
NAME OF TESTING COMPANY
Confidence UST Services, Inc.
PH NE NU17BER
661 631-3870
MAILING ADDRESS
16250 Meacham Road, Bakersfield, CA 93314
NAME OF TESTER
Frank Landa
ICC#
8018524-U1
THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS
PERMIT AND ANY OTHER STATE, LOCAL, AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER
PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT.
NAME OF TESTER
Frank Landa
ICC#
8018524-U1
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED
APPROVED BY 9:n')n%z9 (Dow Oqlf)Q)'
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 - 326 -3979 • Fax: 661- 852 -2171
Page 1 of 1
TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY
X .. r 7-r A- TneI �r 1—Af TI T-M/ MTNInD KAnnTGTrATTn1\1 Ol' PA(-T1 T'T'Y
kI-I IL.%.e, viva v I ---
STARTING DATE/ 04/28/2014 PROPOSED
COMPLETION DATE 05/02/2014
FACILITY NAME Fastrip #6
EXISTING FACILITY PERMIT #
FACILITY ADDRESS 1640 South Chester Avenue
CITY Bakersfield
ZIP CODE 93304
TYPE OF BUSINESS GDF
APN #
TANK OWNER J-aco Hill
PHONE # (6 61) 393-7000
ADDRESS
PO Box 82515
CITY
Bakersfield
ZIP CODE
93380 -2515
CONTRACTOR
Confidence UST Services, Inc.
CA LICENSE #
1804904
ICC #
8018524 -U1
ADDRESS
16250 Meacham Road
CITY Bakersfield
ZIP CODE
93314
PHONE #
(661) 631 -3870 1
BAKERSFIELD CITY BUSINESS LICENSE #
32864
WORKMANS COMP #
1308371 -2013
INSURER
State Fund
BRIEFLY DESCRIBE THE WORK TO BE DONE: Excavate In front of each UDC to install Bravo
Penetrations and test boots. Install Bravo Penetrations on all entry
points STP sumps.
WATER TO FACILITY PROVIDED BY
DEPTH TO GROUND WATER SOIL
TYPE EXPECTED AT SITE
# OF TANKS TO BE INSTALLED
ARE THEY FOR MOTOR FUEL?
SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
❑ YES ❑ NO
❑ YES ❑ NO
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
TANK #
VOLUME
UNLEADED
REGULAR
PREMIUM
DIESEL
OTHER
1
12000 gal.
X
X
2
12000 gal.
X
X
3
12000 gal.
X
X
4
12000 gal.
X
Tank Testing Company
NAME OF TESTING COMPANY
Confidence UST Services, Inc.
PH NE NUMBER
661) 631 -3870
MAILING ADDRESS
16250 Meacham Road, Bakersfield, CA 93314
NAME OF TESTER
Frank Landa
ICC#
8018524 -U1
THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS
PERMIT AND ANY OTHER STATE, LOCAL, AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER
PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT.
NAME OF TESTER
ICC#
8018524 -U1
Frank Landa
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED
APPROVE BY
`"� " 77
FD2086 (Rev 08/09)
SITE PLOT PLAN for:
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1640 S. CHESTER AV9.
BAKERSFIELD, CA 93304
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If you have achieved a NAFED certification you must notify NAFED of any change of address. wywi.nafed.orls,
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Best wishes for continued success in your career, and thank you for your interest in the Certification Programs of the
international Code Council.
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