HomeMy WebLinkAboutMinor Mod Permit App 6-30-16UNDERGROUND STO G E TANK
.. ..:
PERMIT APPLICATION x I D
TO CONSTRUCT - INSTALL NEW TANK (NEW FACILITY) /NEW *A.13TIN41,
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD
H.
Permit # f _10060
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 -326 -3979 ® Fax: 661• -852 -2171
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TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY
CHECK ONE ONLY) ❑ MODIFICATION OF FACILITY 0 MINOR MODIFICATION OF FACILITY
STARTING DATE/
PROPOSED COMPLETION DATE
05/17/2016
5/17/16
FACILITY NAME
EXISTING FACILITY PERMIT #
Sully's Downtown
FACILITY ADDRESS
CITY
ZIP CODE
2317 L Street 6SO071A
Bakersfield
93301
TYPE OF BUSINESS
APN #
GDF
TANK OWNER
PHONE #
Sully's Food Store, LLC
(661) 327 -5008
laced isotrol relay in 87 turbine.
I WATER TO FACILITY PROVIDED BY
I DEPTH TO GROUND WATER
SOIL TYPE EXPECTED AT SITE
NAME OF TESTING COMPANY PHONE NUMBER
Confidence UST Services Inc. 661 -631 -3870
MAILING ADDRESS
16250 Meacham Road, Bakersfield, CA 93314
NAME OF TESTER I 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#
Austin Sterling I 8339953 -UT
FOR OFFICIAL USE ONLY
DATE APPROVED APPROVED BY
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