HomeMy WebLinkAbout10-15 UST APPLICATIONTYPE OF APPLICATION:
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BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 - 326 -3979 • Fax: 661 -852 -2171
Page 1 of 1
❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY
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STARTING DATE/
10/26/2015
PROPOSED COMPLETION DATE
10/30/2015
FACILITY NAME
White Lane Chevron
EXISTING FACILITY PERMIT #
FACILITY ADDRESS
2525 White Lane
CITY
Bakersfield
ZIP CODE
93304
TYPE OF BUSINESS
GDF
APN #
TANK OWNER
Proactive Properties, Inc. dba White Lane Chevron
PHONE #
661 -832 -9781
ADDRESS
2525 White Lane
CITY
Bakersfield
ZIP CODE
93304
CONTRACTOR
Confidence UST Services Inc.
CA LICENSE #
1 804904
ICC #
8177076 -U1
ADDRESS
16250 Meacham Road
CITY
Bakersfield
ZIP CODE
93314
PHONE #
661 - 631 -3870 1
BAKERSFIELD CITY BUSINESS LICENSE #
32864
WORKMANS COMP #
1308371
INSURER
SCIF
BRIEFLY DESCRIBE THE WORK TO BE DONE:
Break out concrete to replace UDC's with like for like shallow bravo pans. Replace all shear valves, flex lines and flexible rubber secondary boots. Replace concrete after pre- backfill inspections.
Perform final sb989 testing and submit results. Replace 3 existing annular Ronan sensors with new Veeder -Root 794390 -409 sensors.
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 n NO
SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
n YES NO
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
TANK #
VOLUME
UNLEADED
REGULAR
PREMIUM
DIESEL
OTHER
1
12000
x
x
2
12000
x
x
3
12000
x
Tank Testing Company
NAME OF TESTING COMPANY
Confidence UST Services Inc.
PHONE NUMBER
661 -631 -3870
MAILING ADDRESS
16250 Meacham Road, Bakersfield, CA 93314
NAME OF TESTER
ICC#
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#
8180171 -U1
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED % % %
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APPROVED BY
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