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Home My WebLink AboutMinor Mod Permit App 12-22-16UNDERGROUND STORAGE TANK PERMIT APPLICATION TO CONSTRUCT - INSTALL NEW TANK (NEW FACILITY) /NEW TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD' Permit # BAKERSFIELD FIRE DEPARTMENT Prevention Services $ 2101 H Street B E R 3 qin Bakersfield, CA 93301 FIRE Phone: 661 - 326 -3979 • Fax: 661- 852 -2171 ARTlI! T Page Iof1 TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY [( -WGry nK11= ni\il Vl 171 MnnTFTrATTnN (1F FACTI TTY ❑ NEW TANK INSTALL/ EXISTING FACILITY MV MTNnR mr)r)TFT( -ATTON nF FACTI TTY STARTING DATE/ 09/01/2016 19/1/16 PROPOSED COMPLETION DATE FACILITY NAME Fastrip EXISTING FACILITY PERMIT # FACILITY ADDRESS 4800 Fairfax Road CITY Bakersfield, CA ZIP CODE 93306 TYPE OF BUSINESS GDF APN # TANK OWNER Fastrip Oil Company PHONE # (661) 393 -7000 ADDRESS P.O. Box 82515 CITY Bakersfield, CA ZIP CODE 93380 -2515 CONTRACTOR Confidence UST Services Inc. CA LICENSE # 804904 ICC # 8022804 -UT ADDRESS 16250 Meacham Road CITY Bakersfield ZIP CODE 93314 PHONE # 661 -631 -3870 1 BAKERSFIELD CITY BUSINESS LICENSE # 32864 WORKMANS COMP # 1308371 INSURER SCIF BRIEFLY DESCRIBE THE WORK TO BE DONE: SB 989 repairs: Replace penetratation boots in UDC's. 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 rl 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 Tanks 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 Cameron Mason ICC# 8174721 -UT THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY ruzuoo (Kev Vo /U7J