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Home My WebLink AboutFMC APP 9-20-18UNDERGROUND STORAGE TANK �t FACILITY NAME PAN PACIFIC DBA WORLD OIL 4:- PERMIT APPLICATION r TO CONSTRUCT - INSTALL NEW TANK (NEW FACILITY) /NEW y.. TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD TANK OWNER PAN PACIFIC DBA WORLD OIL Permit # ADDRESS CITY BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661- 326 -3979 9 Fax: 661 -852 -2171 Page 1of1 TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY C i- A'rTnnl nC CA/T1 r-r'V M MTKInR MnnTFTrn-r rw nF FArT1 T-rY STARTING DATE/ 7-30-18 PROPOSED COMPLETION DATE 8 -30 -18 FACILITY NAME PAN PACIFIC DBA WORLD OIL EXISTING FACILITY PERMIT # FACILITY ADDRESS 1850 COFFEE RD CITY BAKERSFIELD ZIP CODE 93308 TYPE OF BUSINESS APN # TANK OWNER PAN PACIFIC DBA WORLD OIL PHONE # 661 - 679 -9154 ADDRESS CITY ZIP CODE CONTRACTOR BSSR INC, CA LICENSE # ICc #5257282 ADDRESS 6630 ROSEDALE HWY #B CITY BAKERSFIELD ZIP CODE 93308 PHONE # 661- 588 -2777 BAKERSFIELD CITY BUSINESS LICENSE # 1800110762 WORKMANS COMP # 22667 INSURER ACE AMERICAN INS BRIEFLY DESCRIBE THE WORK TO BE DONE: REPLACE EXISTING CNI FILL SPILL BUCKET ALONG WITH 36" LID AND PERFORMED HYDROSTATIC TEST 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 MANUFACTURER 1 10,000 X Tank Testing Company NAME OF TESTING COMPANY BSSR INC, PHONE NUMBER 661 - 588 -2777 MAILING ADDRESS 6630 ROSEDALE HWY #B NAME OF TESTER FIDEL CARRILLO ICC# 5257282 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 FIDEL CARRILLO ICC# 5257282 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY Fn7086(Rev 1112015)