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Home My WebLink AboutMINOR MOD APP 9-5-18BAKERSFIELD 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 (CHFCK nNF nNl Yl n Mnr)TFTCATTnN nF FACTI TTY W MTNnR MnI7TFTCATTON OF FACTI TTY STARTING DATE/ 8/27/18 19/01/18 PROPOSED COMPLETION DATE FACILITY NAME Howard's Mini Mart #3351 EXISTING FACILITY PERMIT # 15-021 -46941 FACILITY ADDRESS 3200 Panama Ln CITY Bakersfield ZIP CODE 93313 TYPE OF BUSINESS C -Store / Gas Station APN # - TANK OWNER Jaco Hill PHONE # 661- 393 -7000 ADDRESS PO Box 82515 CITY Bakersfield ZIP CODE 93380 CONTRACTOR Jaco Oil Company CA LICENSE # 970529 ICC # 8723752 ADDRESS PO Box 82515 CITY Bakersfield ZIP CODE 93380 PHONE # 661 -868 -9484 BAKERSFIELD CITY BUSINESS LICENSE # WORKMANS COMP # WC3486600 INSURER American Zurich Ins. Co. BRIEFLY DESCRIBE THE WORK TO BE DONE: Replace Existing Spill buckets to accommodate a 5 gallon minimum capacity. WATER TO FACILITY PROVIDED BY DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE # OF TANKS TO BE INSTALLED 0 ARE THEY FOR MOTOR FUEL? ❑ YES ❑ NO SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? N YES ❑ NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER Tank Testing Company NAME OF TESTING COMPANY Jaco Oil PHONE NUMBER 661 -633 -7508 MAILING ADDRESS PO Box 82515 Bakersfield, CA 93380 NAME OF TESTER Brian Williams ICC# 8723752 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# THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY