HomeMy WebLinkAboutMinor Mod Permit App 6-2-16BAKERSFIELD FIRE DEPARTMENT
UNDERGROUND STORAGE TANK
Prevention Services
1501 Truxtun Avenue, 1st Floor
PERMIT APPLICATION
g S P
Bakersfield, CA 93301
TO CONSTRUCT- INSTALL NEW TANK (NEW FACILrM /NEW
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Phone: 661 -326 -3979 • Fax: 661 -852 -2171
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD
;Permit #
Page 1 of 1
TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY D—
IVEWJANK I NG FACILITY
CHECK ONE ONLY ❑ MODIFICATION OF FACILITY Dr
MINOR MODIFICATION OF FACI
STARTING DATE/
PRO POSkD .Gt31N
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FACILITY NAME
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�XISI'FNG FACiLT.TYPERMiT
FACILITY ADDRESS
ZIP CODE
TYPE OF BUSINESS
APN #
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TANK OWNER
PHONE #
ADDRESS 5
CITY
ZIP CODE
66NTRACTOR1.
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CA LI
ICC #
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ADDRESS
CifY
ZIP C
PHOl+lE #
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6AKERS INESS,; CENSE
1f{tOi�bCMANS C�fMP #
INSURER
BRIEFLY DESCRIBE THE WORK TO BE DONE: _ I
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