HomeMy WebLinkAboutMINOR MOD APP 9-6-18UNDERGROUND STORAGE TANK
r..
....._. ..
H E R S F 1 ..0
PERMIT APPLICATION
FIRE ,Y
A I�TM T
TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD
CrTY BAKERSFIELD
Permit #
TYPE OF BUSINESS
GASOLINE DISPENSING FACILITY
APN #
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
..... ,. n a.P% CA T1 TT1/ M MTNInD Mr)nTFTrATTf11Y r)F FArT1 TTY
`..IILI. -1`+ tltVL. %atML - I ) u -.v....a..r -
STARTING DATE/ 8 -15 -18 PROPOSED
COMPLETION DATE 9 -15 -18
FACILITY NAME
7
XI ESTING FACILITY PERMIT #
SAYEGH GROUP INC,
FACILITY ADDRESS 2800 PANAMA LANE
CrTY BAKERSFIELD
ZIP CODE 93313
TYPE OF BUSINESS
GASOLINE DISPENSING FACILITY
APN #
TANK OWNER
PHONE # 661 -835 -0643
ADDRESS
CITY
ZIP CODE
CONTRACTOR
BSSR INC,
CA LICENSE #
1 672812
ICC # 5257282
ADDRESS 6630 ROSEDALE HWY #B
CITY BAKERSFIELD
ZIP CODE 93308
PHONE # 661 -588 -2777 BAKERSFIELD CITY BUSINESS LICENSE # WORKMANS COMP # 22667 LA AMERICAN INS
BRIEFLY DESCRIBE THE WORK TO BE DONE:
REPLACE VAPOR SPILL BUCKET IN TANK 1 AND TANK 2, MAKE REPAIRS TO 87 -TANK 1
STP SUMP HAS TORN BOOT PERFORM HYDROSTATIC AFTER REPAIRS
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?
❑ YES ❑ NO 10
YES ❑ NO
THIS SECTION IS FOR STORAGE TANK EDEf TIFECATION
TANK #
VOLUME
UNLEADED
REGULAR
PREMIUM
DIESEL
OTHER
TANK MANUFACTURER
1
X
2
X
3
X
Tank Testing Company
NAME OF TESTING COMPANY BSSR INC,
ATPHONE 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 PER3URY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT.
NAME OF TESTER
FIDEL CARRILLO
YCC#
5257282
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED
APPROVED BY
FD2086 (Rev 11/2015)