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HomeMy WebLinkAboutMinor Mod Permit App 11-2-16PRO Permit # Qo 5-1% TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY CHECK ONE ONLY MODIFICATION OF FACILITY MINOR MODIFICATION OF FACILITY STARTING DATE/ PROPOSED COMPLETION DATE 08/27/2016 8/27/1'6 FACILITY NAME EXISTING FACILITY PERMIT # ? Fastrip FACILITY ADDRESS CITY ZIP CODE 4800 Fairfax Road Bakersfield, CA 93306 TYPE OF BUSINESS APN # GDF TANK OWNER PHONE # Fastrip Oil Company (661) 393 -7000 ADDRESS CITY ZIP CODE P.O. Box 82515 Bakersfield, CA 93380 -2515 BRIEFLY DESCRIBE THE WORK TO BE DONE: Replace existing OPW drop tube with flapper valve with new OPW straight drop tube on the 87 UNL tank. WATER TO FACILITY PROVIDED BY DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE # OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL? SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? 1[] YES n NO YES NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION Tank Testing Company NAME OF TESTING COMPANY PHONE NUMBER Confidence UST Services Inc. 661-631 - 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# B 8022804 -UT Bryan Self THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY FD2086 (Rev 08/09