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