HomeMy WebLinkAboutMINOR MOD APP 1.28.19UNDERGROUND STORAGE TANK
PERMIT APPLICATION
TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD
Permit #
TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY
(CHECK ONE ONLY) MODIFICATION OF FACILITY ❑✓ MINOR MODIFICATION OF FACILITY
STARTING DATE/ TP,1/02/2017 ROPOSED COMPLETION DATE .
11 /02/2018
FACILITY NAME
EXISTING FACILITY PERMIT #
Wholesale Fuels, Inc.
FACILITY ADDRESS
CITY
Bakersfield
ZIP CODE
193307
2200 East Brundage Lane
TYPE OF BUSINESS
APN #
Fuel Distribution
TANK OWNER
PHONE #
(661) 327 -4900
Wholesale Fuels, Inc.
ADDRESS
CITY
Bakersfield
ZIP CODE
93307
2200 East Brundage Lane
CA LICENSE #
ICC #
CONTRACTOR
Confidence UST Services Inc.
804904
8174721 -UT
CITY
ZIP CODE
ADDRESS
16250 Meacham Road
Bakersfield
93314
PHONE # BAKERSFIELD CITY BUSINESS LICENSE #
WORKMANS COMP #
1308371
INSURER
SCIF
661 - 631 -3870 32864
BRIEFLY DESCRIBE THE WORK TO BE DONE:
Replace T4 & T6 Fill spill buckets with new Phil -Tite 5 gallon model (MN 85100 -1).
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 M NO YES NO
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
TANK # IVOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER
4 20,000 X X
6 20,000
Tank Testing Company
NAME OF TESTING COMPANY PHONE NUMBER
_ Confidence UST Services, Inc 661-631 -
MAILING ADDRESS
16250 Meacham Road, Bakersfield, CA 93314
NAME OF TESTER I ICC#
X
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#
8414476 -UT
Tim Capehart
DATE APPROVED
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
APPROVED BY
6 (Rev