HomeMy WebLinkAboutMINOR MOD APP 12-4-18PERMIT APPLICATION
TO CONSTRUCT-INSTALL NEW TANK (NEW FACILITY)/NEW
TANK INSTALL (EXISTING FACILITY)/MOD-MINOR MOD
Permit #
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 ® Fax: 661-852-2171
Page I of 1
TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY ❑ NEW TANK INSTALL/ EXISTING FACILITY
(CHECK ONE UNLY) U MUL)III I WIN Ut- I-At-ILI I Y uivUrc 1v1UL)1t-1t,./A I IIJINI Ul- r/Ak-111-1 I T
STARTING DATE/ PROPOSED COMPLETION DATE
FACILIPt. EXISTING FACILITY PERMIT #
4)aAroCk c-1-
FACIL ZIP CODE
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TYPE OF 417WNESS - f.--\ APIN #
CL 'I(
TANK OWNER PHONE #
!ADDRESS
CITY
ZIP CODE
I WATER TO FACILITY PROVIDED BY
I DEPTH TO GROUND WATER
SOIL TYPE EXPECTED AT SITE
# OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL? SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
1
❑ YES ❑ NO 1 ❑ YES ❑ NO
THES SECTION ZS FOR STORAGE 7AHK ZDEM7ZFZCA7Z0'N
TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER
A, ------
lank Testing Company
NAME OF T15T1 COM NY PHONE NUMBER
61 e C-)- 7 1
AILING A�;DRESS
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MAILING LCESC) 4A 'CA I
FOR OFFICIAL USE ONLY
DATE APPROVED APPROVED BY
FD2086 (Rev 11/2015)