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Home My WebLink AboutMINOR MOD APP 7-24-18UNDERGROUND STORAGE TANK 7 PERMIT APPLICATION�� g TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW , s FIRE 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 1 of 1 TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY rr-wG(-v nni;= nnH V) M MnnTFTrA-rrnni nF FArTI T-ry I✓� MTNOP Mnr)TFTrATTON OF FAMI TTY STARTING DATE/ PROPOSED 7/17/18 17/17/18 COMPLETION DATE FACILITY NAME Fastrip #633 EXISTING FACILITY PERMIT # FACILITY ADDRESS CITY 6401 South H Street Bakersfield ZIP CODE 193304 TYPE OF BUSINESS GDF APN # TANK OWNER Jaco Hill PHONE # 661 - 393 -7000 ADDRESS P.O. Box 82515 CITY Bakersfield ZIP CODE 93380 -2515 CONTRACTOR Confidence UST Services Inc. CA LICENSE # 1 804904 ICC # 8374998 -UT ADDRESS CITY 16250 Meacham Road 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 91 Fill Spill Bucket with new 5 gallon Phil -Tite spill bucket (like for like). 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 n NO 11 SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? YES NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER 1 12000 X X 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 Amestoy IV ICC# 8374998 -UT THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY Cr%'MoG /D_" Aft /AD\