HomeMy WebLinkAboutMINOR MOD APP 2.15.19UNDERGROUND STORAGE TANK
PERMIT APPLICATION
TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD
Permit #
..� "'�.. BAKERSFIELD FIRE DEPARTMENT
' Prevention Services
2101 H Street
Bakersfield, CA 93301
'"�...r./ Phone: 661- 326- 3979 o Fax: 661 -852 -2171
Page 1 of 1
TYPE OF APPLICATION: ❑ NEW TANK INSTALL /NEW FACILITY ❑ NEW TANK INSTALL /EXISTING FACILITY
(CHECK ONE ONLY ) U MUUlI-1(.;A 11UIV U1- t-AC:1L11 Y IJ' IvIliVUK IvIUUlI -11.A I IUIV Ur t -AC.lu I T
STARTING DATE/ PROPOSED COMPLETION DATE
FACILITY NAME EXISTING FACILITY PERMIT #
Bashaar Chevron
FACILITY ADDRESS 2301 Panama Ln. CITY Bakersfield ZIP CODE 93307
TYPE OF BUSINESS APN #
Retail gas station
TANK OWNER PHONE #
Bashaar Naidawi 661- 832 -4551
Replace 304 brine sensor in diesel STP, 463 vac sensor (87), and diesel vent 463 vac sensor.
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WATER TO FACILITY PROVIDED BY
DEPTH TO GROUND WATER I SOIL TYPE EXPECTED AT SITE
# OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL? SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
❑ YES ❑ NO 1 ❑ YES ❑ NO
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
NAME OF TESTING COMPANY PHONE NUMBER 661-573-7171 Complete Fueling Solutions
MAILING ADDRESS
12601 Jasmine Avenue Bakersfield CA 93312
NAME OF TESTER ICC#
Aaron Koop 5246167
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 I ICC#
Aaron Koop
5246167
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED APPROVED BY
FD2086 (Rev 11/2015)