HomeMy WebLinkAboutMINOR MOD APP 8-31-18BRIEFLY DESCRIBE THE WORK TO BE DONE:
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WATER TO FACILITY PROVIDED BY'
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 ❑ YES ❑ NO
THIS SECTION HS FOR STORAGE TANK IDENTIFICATION
TANK # VOLUME UNLEADED REGULAR PREMIUM OTHER
BAKERSFIELD FIRE DEPARTMENT
UNDERGROUND STORAGE TANK 1
Preventi ®n Services
PERMIT APPLICATION P
ield, CA 93301
Bakersf
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TO CONSTRUCT-INSTALL NEW TANK (NEW FACILITY)/NEW
TANK INSTALL (EXISTING FACILITY)/MOD-MINOR MOD P
Page 1 of 1
Permit #
TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY ,EL_NEW T
TANK INSTALL/EXISTING FACILITY
❑ MODIFICATION OF FACILITY ?r R
R MODIFICATION OF FACILITY
STARTING DATE/
PROPOSED C
EXISTING FACILITY PERMIT.#
FACI nY NAME
FACILITY ADDRESS l
CITY z
z
TYPE OF BUSINESS A
APN #
TANK OWNER P
PHONE # C
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ADDRESS z
CONTRACTOR 1A
CA ICC 9
ADDRESS O
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CIT)All Z
ZIP
BAKERSF1 ESS Li S
S # W
WORKMANS COMP # I
INSURER
WATER TO FACILITY PROVIDED BY'
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 ❑ YES ❑ NO
THIS SECTION HS FOR STORAGE TANK IDENTIFICATION
TANK # VOLUME UNLEADED REGULAR PREMIUM OTHER