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Home My WebLink AboutMinor Mod Permit App 4-26-16BAKERSFIELD FIRE DEPARTMENT UNDERGROUND STORAGE TANK COMPLETION DATE I,. Prevention Services FACILITY ADDRESS CITY 3701 Ming Avenue Bakersfield 4 JE 2101 H Street PERMIT APPLICATION TANK OWNER Jamieson Hill R 9 P I n Bakersfield, CA 93301 TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW ZIP CODE 93380 -2515 F"�"�` ARTM T Phone: 661 - 326 -3979 •Fax: 661 - 852 -2171 TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD ADDRESS 16250 Meacham Road CITY Bakersfield Page IofI I Permit # /_ 00--f w; WORKMANS COMP # 1308371 INSURER SCIF TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY i�e_i�ry r�neC nn v� n nannTCTr^A-rTnn1 nr7 GArT1 TTV n MTIVnR Mnr)TFTrATTnN OF FAMI TTy STARTING DATE/ PROPOSED 03/26/2016 103/26/2016 COMPLETION DATE FACILITY NAME Fastrip #32 EXISTING FACILITY PERMIT # FACILITY ADDRESS CITY 3701 Ming Avenue Bakersfield ZIP CODE 93309 TYPE OF BUSINESS GDF APN # TANK OWNER Jamieson Hill PHONE # (661) 393 -7000 ADDRESS PO Box 82515 CITY Bakersfield ZIP CODE 93380 -2515 CONTRACTOR Confidence UST Services Inc. CA LICENSE # 1 804904 ICC # 8339953 -UT ADDRESS 16250 Meacham Road CITY Bakersfield ZIP CODE 93314 PHONE # 661 -631 -3870 BAKERSFIELD CITY BUSINESS LICENSE # 32864 WORKMANS COMP # 1308371 INSURER SCIF BRIEFLY DESCRIBE THE WORK TO BE DONE: Replace relay on 91 turbine. 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 F1 SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? 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 Austin Sterling ICC# 8339953 -UT THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY Fn ?nR6 (Rev 08/09)