HomeMy WebLinkAboutUST-APPL 3/31/2015PERMIT APPLICATION
TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD
Permit
TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY
CHECK ONE ONLY
MODIFICATION OF FACILITY U MINOR MODIFICATION OF FACILITY
STARTING DATE/
PROPOSED COMPLETION DATE
03/31/2015
03/31 /2015
FACILITY NAME
EXISTING FACILITY PERMIT #
Arco AM PM
FACILITY ADDRESS
CITY
ZIP CODE
2301 F Street
Bakersfield
93301
TYPE OF BUSINESS
APN #
Gasoline Dispensing Facility
003 - 112 -05
TANK OWNER
PHONE #
Sam Stardust Enterprises, Inc.
(661) 721 -8911
ADDRESS
CITY
ZIP CODE
2301 F Street
Bakersfield
93301
CONTRACTOR
CA LICENSE #
ICC #
• Conf idence UST Services j Inc-
.80 9 04
8180171 -u1
ADDRESS
CITY
ZIP CODE
o
16250 Meacham Po:
Bakersfield
93314
PHONE #
BAKERSFIELD CITY BUSINESS LICENSE #
WORKMANS COMP #
1308371
INSURER
SCIF.
661 - 631 -3870
32864
BRIEFLY DESCRIBE THE WORK TO BE DONE: