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Home My WebLink AboutMINOR MOD & OPI APP 12.26.18PERMIT APPLICATION TO CONSTRUCT - INSTALL NEW TANK (NEW FACILITY) /NEW TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD Permit # I. TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY fruGrLe nRfr_ nnia V) n Mr) 1TFTf aTTr)K1 (1F PArTI TN bA MTNnP MnnTFTrATTON nF FACT1 TTY STARTING DATE/ 11-29-18 PROPOSED Prevention Services FACILITY NAME CIRCLE K #8605 2101 H Street s E R s F, 0 -. FIRE~ N., Bakersfield, CA 93301 ARrN , :r Phone: 661 - 326 -3979 • Fax: 661 - 852 -2171 APN # Page 1ofI TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY fruGrLe nRfr_ nnia V) n Mr) 1TFTf aTTr)K1 (1F PArTI TN bA MTNnP MnnTFTrATTON nF FACT1 TTY STARTING DATE/ 11-29-18 PROPOSED COMPLETION DATE 12-29-18 FACILITY NAME CIRCLE K #8605 1 EXISTING FACILITY PERMIT # FACILITY ADDRESS 5600 AUBURN ST CCTV BAKERSFIELD ZIP CODE 93306 TYPE OF BUSINESS GASOLINE DISPENSING FACILITY APN # TANK OWNER CIRCLE K PHONE # 661-871-6273 ADDRESS 5600 AUBURN ST CITY ZIP CODE CONTRACTOR BS S R INC, CA LICENSE # ICC # 5309490 ADDRESS 6630 ROSEDALE HWY #B CITY BAKERSFIELD ZIP CODE 93308 PHONE # BAKERSFIELD CITY BUSINESS LICENSE # WORKMANS COMP # INSURER BRIEFLY DESCRIBE THE WORK TO BE DONE: REPAIR /REPLACE OVERFILL PREVENTION VALVE TO MEET THE 95016 OVERFILL REQUIREMENT OVERFILL PREVENTION VALVE REPLACEMENT / OPW 71 SO -410C UPON COMPLETION, WILL NOTIFY FIRE DEPT, OF REPAIRS MADE & SCHEDULE TEST TO VERIFY PROPER OPERATION 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 ❑ NO SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? ❑ YES ❑ NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER TANK MANUFACTURER 1 10,000 X 2 10,000 X 3 10,000 X Tank Testing Company NAME OF TESTING COMPANY BSSR INC, PHONE NUMBER 661 -588 -2777 MAILING ADDRESS 6630 ROSEDALE HWY #B NAME OF TESTER SALVADOR SANCHEZ ICC# 5309490 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 SALVADOR SANCHEZ ICC# 5309490 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY m7nAr,, (RPv 11 /20151