The URL can be used to link to this page

Home My WebLink AboutMINOR MOD APP 12.13.18JNDERGROUND STORAGE 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 .n, .r..!/ AA -ft 1 %0% A'TT!'1N nc CAI -TI TrV hd MTKirw Mnr1TFTrATTnN nF FArTI TTY STARTING DATE/ 12-13-18 PROPOSED BAKERSFIELD FIRE DEPARTMENT FACILITY NAME CIRCLE K #1270 Prevention Services FACILITY ADDRESS 5643 STI N E RD 2101HStreet a ERSF1 .` 0 FIRE.. Bakersfield, CA 93301 ,aRr r Phone: 661 - 326 -3979 • Fax: 661- 852 -2171 PHONE # 661-834-8625 Page 1 of 1 TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL/EXISTING FACILITY .n, .r..!/ AA -ft 1 %0% A'TT!'1N nc CAI -TI TrV hd MTKirw Mnr1TFTrATTnN nF FArTI TTY STARTING DATE/ 12-13-18 PROPOSED COMPLETION DATE .1-13-19 FACILITY NAME CIRCLE K #1270 EXI NG FACILITY PERMIT# FACILITY ADDRESS 5643 STI N E RD BAKERSFI ELD ZIP c °DE93313 TYPE OF BUSINESS GASOLINE DISPENSING FACILITY APN # TANK OWNER CIRCLE K PHONE # 661-834-8625 ADDRESS CITY ZIP CODE CONTRACTOR B S S R I N V CA LICENSE # 672812 ICC 5257282 ADDRESS 6630 ROSEDALE HWY #B ` BAKERSFIELD zIPC °DE PHONE # 661- 588 -2777 BAKERSFIELD CITY BUSINESS LICENSE # WORKMANS COMP # 22667 G V ACE AMERICAN INS, BRIEFLY DESCRIBE THE WORK TO BE DONE: TANK 1 (87) STP SUMP AND TANK 2 91 VAPOR BUCKET FAIL SB -989 TEST MAKE REPAIRS AS NEEDED TO GET PASSING RESULTS AND TEST WITH FIRE DEPT. 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 107000 X 2 10.000 X Tank Testing company NAME OF TESTING COMPANY BSSp INC, PHONE NUMBER 661-588-2777 MAILING ADDRESS 6630 ROSEDALE HWY #B NAME OF TESTER FIDEL CARRILL® I 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 PERJURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT. NAME OF TESTER FI DEL CARRI LLO I ICC# 5257282 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY FD2dR6 (Rev 11/2015)