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Home My WebLink AboutMinor Mod Permit App. 9-18-15UNDERGROUND STORAGE TANK A PERMIT APPLICATION B B x s p F D TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW FIRS TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD AItfA1 f BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661 -326 -3979 • Fax: 661 -852 -2171 Page 1 of 1 Permit # TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY f(-HFCIC ONF nNl Y) M MOMFTCATTON OF FACTI TTY n MTNt7R monTFTCATTON OF FACTI_TTY STARTING DATE/ 09/18/2015 19/18/15 PROPOSED COMPLETION DATE FACILITY NAME Mt Vernon & Columbus ARCO ( #00371) EXISTING FACILITY PERMIT # FACILITY ADDRESS 2698 Mt Vernon Avenue CITY Bakersfield ZIP CODE 193306 TYPE OF BUSINESS GDF APN # TANK OWNER Abrahim Garas PHONE # (661) 872 -5862 ADDRESS 2698 Mt Vernon Avenue CITY Bakersfield ZIP CODE 93306 CONTRACTOR Confidence UST Services Inc. CA LICENSE # 804904 ICC # 8111231 -UT ADDRESS 16250 Meacham Road CITY Bakersfield ZIP CODE 93314 PHONE # 661 -631 -3570 1 BAKERSFIELD CITY BUSINESS LICENSE # 32864 WORKMANS COMP # 1308371 INSURER SCIF BRIEFLY DESCRIBE THE WORK TO BE DONE: Remove existing CPT leak detector and controller and replace with new Veeder -Root Red Jacket FX1 V line leak detector on 91 line. Replaced 2" product flex line in 87 STP sump. 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 rl NO SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? F1 YES NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER 1 20000 x x 2 12000 x 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 Bradley Seykora ICC# 8111231 -UT THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED 1 APPROVED BY . ruzvoo �Kev U?J /Uy)