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Home My WebLink AboutUST APPL. 7/9/20151 I UNDERGROUND STORAGE TANK PERMIT APPLICATION TO CONSTRUCT-INSTALL NEW TANK (NEW FACILITY)/NEW TANK INSTALL (EXISTING FACILITY)/MOD-MINOR MOD TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY fe-til--r-11 r'lkf= r"%1\11 \/\ M MnMTCTf-A-rTnK1 nr: PArT1 rrV A B A E R S P I MIRE A R rx, fir BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 Page I of 1 ❑ NEW TANK INSTALL/EXISTING FACILITY rV MTrxl()P mr)nT1=T(-ATTnru nF FACTI TTY STARTING DATE/ 7-9-15 PROPOSED COMPLETION DATE 7-9-15 FACILITY NAME 7-11 EXISTING FACILITY PERMIT '# FACILITY ADDRESS 1701 PACHECO RD BAKERSFIELD ZIP CODE 93304 TYPE OF BUSINESS GASOLINE DISPENSING FACILITY APN # TANK OWNER 7-11 PHONE # 661-834-1350 ADDRESS 1701 PACHECO RD CITY BAKERSFIELD ZIP CODE 03304 CONTRACTOR BSSR INC, LICENSE # 572812 # 5257282 ADDRESS . 6630 ROSEDALE HWY #B CITY BAKERSFIELD ZIP CODE 93308 PHONE # 661-588-2777 BAKERSFIELD I CITY BUSINESS LICENSE # 1500110762 WORKMANS COMP # 22667 INSURER ACE AMERICAN BRIEFLY DESCRIBE THE WORK TO BE DONE: REPLACE 87 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 ❑ NO SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? ❑ YES ❑ NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION TANK # > VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER 10,000 X 2 10,000 X 3 10,000 X Tank Testing Company NAME OF TESTING COMPANY BSSR INC, PHONE NUMBER 661-588-2777 MAILING ADDRESS 6630 ROSEDALE HWY #B NAME OF TESTER FIDEL CARRILLO ICC# 5257282 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 PER3URY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT. NAME OF TESTER FIDEL CARRILLO ICC# 5257282 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY (0." nsz/nol