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Home My WebLink AboutMinor Permit Appn 11-14-16UNDERGROUND T TANK PERMIT APPLICATION TUCONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD Permit # Z01 Page 1 of 1 TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY ❑ NEW TANK INSTALL/EXISTING FACILITY (CHECK ONE ONLY) ❑ MODIFICATION OF FACILITY N5�MI OR MODIFICATION OF FACILITY STARTING DATE/ PROPOSED COMPIION DATE FACILITY N7ME 1 EXISTING FACILITY PERMIT # FACILIDD�RES C IV I ZIPD.E TYPE OF BUSINESS --- APN # e TANK OWNER u I PHONE # WATER TO FACILITY PROVIDED BY DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE # OF TANKS TO BE INSTALLED I ARE THEY FOR MOTOR FUEL? SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? ❑ YES ❑ NO 1 ❑ YES ❑ NO THIS SECTION IS FOR STORAGE TANK IDEN57EFECATHON TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER TANK MANUFACTURER Tank Testing Company NAME-AE TESTING COMPANY I PHON�A9j4BFR MAILING ADDRESS FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY Zy- o-- FD2086 (Rev 11/2015) BAKERSFIELD FIRE DEPARTMENT w- Prevention Services Aa 2101 HStreet FIRE Bakersfield, CA 93301 'R Phone: 661 -326 -3979 ® Fax: 661- 852 -2171 Page 1 of 1 TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY ❑ NEW TANK INSTALL/EXISTING FACILITY (CHECK ONE ONLY) ❑ MODIFICATION OF FACILITY N5�MI OR MODIFICATION OF FACILITY STARTING DATE/ PROPOSED COMPIION DATE FACILITY N7ME 1 EXISTING FACILITY PERMIT # FACILIDD�RES C IV I ZIPD.E TYPE OF BUSINESS --- APN # e TANK OWNER u I PHONE # WATER TO FACILITY PROVIDED BY DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE # OF TANKS TO BE INSTALLED I ARE THEY FOR MOTOR FUEL? SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? ❑ YES ❑ NO 1 ❑ YES ❑ NO THIS SECTION IS FOR STORAGE TANK IDEN57EFECATHON TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER TANK MANUFACTURER Tank Testing Company NAME-AE TESTING COMPANY I PHON�A9j4BFR MAILING ADDRESS FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY Zy- o-- FD2086 (Rev 11/2015)