HomeMy WebLinkAboutminor app 8-3-18BAKERSFIELD FIRE DEPARTMENT
UNDERGROUND STORAGE TANK Prevention Services
2101 H Street
PERMIT APPLICATION B $ R s R i D Bakersfield, CA 93301
TO CONSTRUCT - INSTALL NEW TANK (NEW FACILITY) /NEWfirs Phone: 661 - 326 -3979 •Fax: 661- 852 -2171
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD ' ARf
Page 1 of 1
Permit #
TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY
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STARTING DATE/ PROPOSED
COMPLETION DATE
10/15/2018 10/15/18
FACILITY NAME
EXISTING FACILITY PERMIT #
Plaza Towers
FACILITY ADDRESS
CITY
ZIP CODE
193309
3015 Wilson Road
Bakersfield
TYPE OF BUSINESS
APN #
Generator tank
TANK OWNER
PHONE #
Housing Authority of the County of Kern
661- 631 -8500 ex. 2406
ADDRESS
CITY
ZIP CODE
601 24th Street
Bakersfield
93301
CONTRACTOR
CA LICENSE #
1
ICC #
Confidence UST Services Inc.
804904
8180171 -U1
ADDRESS
16250 Meacham Road
CITY
Bakersfield
ZIP CODE
93314
PHONE #
1
BAKERSFIELD CITY BUSINESS LICENSE #
WORKMANS COMP #
1308371
INSURER
SCIF
661 -631 -3870
32864
BRIEFLY DESCRIBE THE WORK TO BE DONE:
Correct safe suction system to be properly operable.
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 rl
YES NO
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
TANK #
VOLUME
UNLEADED
REGULAR
PREMIUM
DIESEL
OTHER
1
300 gal.
x
Tank Testing Company
NAME OF TESTING COMPANY
PHONE NUMBER
Confidence UST Services Inc.
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
ICC#
8180171 -U1
Frank Landa
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED
APPROVED BY
M2086 (Rev 08/09)