HomeMy WebLinkAboutUST-APPL. 6/1/2016(CHECK ONE ONLY ✓ MODIFICATION OF FACILITY Lj MINOR MODIFICATION OF FACILITY
STARTING DATE/ JPR
OP OSED COMPLETION DATE
BAKERSFIELD FIRE DEPARTMENT
UNDERGROUND STORAGE TANK
FACILITY NAME
EXISTING ;FACILITY PERM
Prevention Services
PERMIT APPLICATION
A
2101 H Street
Bakersfield, CA 93301
ZIP CODE
1800 Golden State Avenue
YRF
193301
TO CONSTRUCT-INSTALL NEW TANK (NEW FACILITY)/NEW
APN #
rNA
+ Abi I VIT
Phone: 661-326-3979 • Fax: 661-852-2171
TANK INSTALL (EXISTING FACILITY)/MOD-MINOR MOD
PHONE #
A&AW91111h,
Page I of 1
ADDRESS
CITY
ZIP CODE
2001 South Manchester Avenue
lPermit #
92802
C ONTRACTOR " . �: , :: J,
CA LICENSE 4
TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW
Confidence UST Services, Inc.
FACILITY ❑
NEW TANK INSTALL/EXISTING FACILITY
(CHECK ONE ONLY ✓ MODIFICATION OF FACILITY Lj MINOR MODIFICATION OF FACILITY
STARTING DATE/ JPR
OP OSED COMPLETION DATE
4/26/16
1,
4/26/16
FACILITY NAME
EXISTING ;FACILITY PERM
Pacific Coast Sightseeing & Charters
FACILITY ADDRESS
CITY
ZIP CODE
1800 Golden State Avenue
I Bakersfield
193301
TYPE OF BUSINESS
APN #
Transportation
TANK OWNER
PHONE #
Pacific Coast Sightseeing & Charters
(714) 507-3101
ADDRESS
CITY
ZIP CODE
2001 South Manchester Avenue
Anaheim, CA
92802
C ONTRACTOR " . �: , :: J,
CA LICENSE 4
I .
Confidence UST Services, Inc.
8 04 9 04:,!:::
U.1/ U T
ADDRESS
CITY
ZIP.CODE L.,
16250 Meacham Road
Bakersfield
314
9 3:
PHONE #
BAKERSFIELD CITY BUSINESS LICENSE #
WORKMANS.CPM,P #
INSUkER,
661—,631-3870
32864
BRIEFLY DESCRIBE THE WORK TO BE DONE:
Break out a 2'x2' area of concrete to expose electrical conduit for annular sensor to repair broken j box. Install new seal off and new j box. Test sensor
I WATER TO FACILITY PROVIDED BY
I DEPTH TO GROUND WATER
SOIL TYPE EXPECTED AT SITE
Tank Testing Company
NAME OF TESTING COMPANY
Confidence UST Servii
MAILING ADDRESS
16250 Meacham Road,
NAME OF TESTER
PHONE NUMBER
Inc. 1 661-631-3870
Bakersfield, CA 93314
1 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 ICC#
Frank Landa 8180171-U1 /UT
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED APPROVED BY
FD2086 (Rev 08/09)