HomeMy WebLinkAboutUST-APPL 10/26/2014TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY
(CHFCIC ONF ONLY) ❑ MODTFTCATION OF FACILITY P9 MINOR MODIFICATION OF FACTLTTY
STARTING DATE/ 10/26/14
PROPOSED COMPLETION DATE 10/26/14
FACILITY NAME
Sparkling Image Carwash (Chevron)
EXISTING FACILITY PERMIT #
FACILITY ADDRESS
2301 H Street
CITY
Bakersfield
ZIP CODE
93301
TYPE OF BUSINESS G,yDF
APN #
TANK OWNER
Wash Depot Holdings, Inc.
PHONE #
ADDRESS 14 Summer Street, Suite 302
CITY Maiden, MA
ZIP CODE 02148
CONTRACTOR
Confidence UST Services Inc.
CA LICENSE #
804904
ICC #
8216722 -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: Replace flex line in 87 STP sump.
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
Tank 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
Frank Landa
ICC#
8180171 -U1
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED
APPROVED BY