HomeMy WebLinkAboutUST-APPLBAKERSFIELD FIRE DEPARTMENT
UNDERGROUND STORAGE TANK 4 Prevention Services
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1600 Truxtun Ave. , Suite 401
PERMIT APPLICATION B
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E R. S P 1
a Bakersfield, CA 93301
TO CONSTRUCT - INSTALL NEW TANK (NEW FACILITY) /NEW m
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A R T
Phone: 661- 326 -3979 • Fax: 661- 852 -2171
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD
Page 1 of 1
Permit # 1
TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY
❑ NEW TANK INSTALL /EXISTING FACILITY
(CHECK ONE ONLY ) ❑ MODIFICATION OF FACILITY
C1, - "MINOR MODIFICATION OF FACILITY
STARTING DATE/
PROPOSED COMPLETION DATE
FACILITY NAME
EXISTING FACILITY PERMIT #
FACILII-TyyY ADDRESS
ZIP CODE
TYPE OF BUSINESS _
APN #
TANK OWNER
PHONE # `}
ADDRESS
CITY
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ZIP CODE
933 C�A
CONTRACTOR
CA LICENSE #
ICC #
ADDR SS
C=_
,
ZIP CODE
PHONE #
BAKERSFIELD CITY BUSINESS LICENSE:#
WORKMANS CQMP #
INSURER
BRIEFLY DESCRIBE THE WORK TO BE DONE:
THIS APPLICATION BECOMES A PERMIT WFtk PROVED
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