HomeMy WebLinkAboutMINOR APP 2.6.19BAKERSFIELD FIRE DEPARTMENT
UNDERGROUND STORAGE TANK Prevention Services
,rho 2101 H Street
PERMIT APPLICATION Bakersfield, CA 93301
TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW � --� Phone: 661 -326 -3979 e Fax: 661 -852 -2171
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD Page 1 of 1
jPe mit #
TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY
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STARTING DATE /TBD PROPOSED COMPLETION DATE TBD
EXISTING FACILITY PERMIT #
FACILITY NAME
Fastrip #26
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CITY Bakers) leld ZIP CODE 93306
FACILITY ADDRESS
2698 Oswell Street
TYPE OF BUSINESS GDF APN #
f
TANK OWNER
Jaco Hill PHONE # 661_393-7000
ADDRESS CITY Bakersfield, CA ZIP CODE 93380 -251
PO Box 82515
CONTRACTOR Confidence UST Services, Inc. CA LICENSE # 804904 ICC # 8414476
ADDRESS 16250 Meacham Road
CITY Bakersfield
ZIP CODE 93314
WORK 196�S?i'�1 #2018
INSURER Fund
PHONE # FIELD CITY BUSINESS LICENSE #
661.631 "3870 132864
BRIEFLY DESCRIBE THE WORK TO BE DONE:
Replace 87 Master & 87 Slave drop tube with new OPW 71 SO 41 OCT model.
WATER TO FACILITY PROVIDED BY
DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE
# OF TANKS TO BE INSTALLED E THEY FOR MOTOR FUEL? SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
70
E31 YES 13 NO ❑ YES ❑ NO O
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER
1 12000 X X
2 12000 X X
"rank Testing Company
NAME OF TESTING COMPANY PHONE NUMBER
MAILING ADDRESS
NAME OF TESTER
ICC#
UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS
THE APPLICANT HAS RECEIVED,
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#
I 8414476
Tim Capehart
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL. USE ONLY
DATE APPROVED
APPROVED BY
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