HomeMy WebLinkAboutMINOR MOD APP_8.29.18UNDERGROUND STORAGE TANK
TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY)/NEW
TAN K .. STALL `_ .
TYPE OFAPPL|CAT|ON: NEW TANK INSTALL/NEW FACILITY
BAKERSF|EL[) FIRE DEPARTMENT
Prevention Services
2101 HQtreet
Bakersfield, CAS33O1
Phone. 681-326'3978 eFox: 681-852-2171
Page of 1
M NEW TANK INSTALL/EXISTING FACILITY
STARTING DATE/ PROPOSED
Within 30 days of approval date
COMPLETION DATE
Within 30 days of start date
AT&T (SA002)
FACILITYADDRESS
1520 20th St.
CITY
Bakersfield CA. 193301-4406
ZIP CODE
TYPE OF BUSINESS
Communications
APN #
TANK OWNER
Pacific Bell Telephone dba AT&T California
PHONE #
(800) 566-9347
ADDRESS
308 S. Akard St. RN 1700
TY
TD'a a s TX.
ZIP CODE
75202
.California Hazardous Services Inc
17:34854
ADDRESS
P.O. Box 5095 RM 4W200M
CITY
Santa Ana CA.
ZIP CODE
92705
PHONE#
(214) 464-5.591
BAKERSFI ELD C1 TY BUS[ NESS Ll CENSE #
11400124248
WORKMANS COMP #
C48834620
INSURER.
ACE American Ins-Co;
BRIEFLY DESCRIBE THE WORK TO BE DONE:
Piping & Transition Sump Supply & Retun Line Penetrations to be replaced from within sump.
WATER TO FACI Ll TY PROVIDED BY
DEPTH TO GROUND WATER
SOIL TYPE EXPECTED AT SITE
# OF TANKS TO BE INSTALLED
ARE THEY FOR MOTOR FUEL? SPILL
Iff] YES El NO
PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
El YES NO
TANK #
VOLUME
UNLEADED
REGULAR
PREMIUM
DIESEL
OTHER
TANK MANUFACTURER
8'K
X
Modem Welding
Tank Testing Company
NAME OF TESTI NG COMPANY
Tait Environmental —7714)
PHONE NUMBER
560-8200
701 Park Center Dr. Santa Ana CA. 92705
NAME OF TESTER
[CC#
THE APPLI CANT HAS RECEIVED, UNDERSTANDS, AND WI LL COMPLY WITH THE ATTACHED CONDI TI ONS OF THI S
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 I S TRUE AND CORRECT.
NAME OF TESTER
I CC#
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFF1 C1 AL USE ONLY
DATE APPROVED
APPROVED BY