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Home My WebLink AboutMINOR MOD APP 7.22.19BAKERSFIELD FIRE DEPARTMENT UNDERGROUND STORAGE TANK _.__.. Prevention Services COMPLETION DATE 1Y262019 7�2019 2101 H Street PERMIT APPLICATION a F 1 P Bakersfield, CA 93301 TO CONSTRUCT - INSTALL NEW TANK (NEW FACILITY) /NEW �IRI fAR/I f Phone: 661 - 326 -3979 Fax: 661 - 852 -2171 TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD � Page 1 of 1 93308 1. OF BUSINESS ' GDF Permit # PHONE # Jamieson HIII (661) 393 -7000 TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY ❑ NEW TANK INSTALLIEXISTING FACILITY ZIP CODE fil T.n. MnnTFTrATInN OF FACTI ITV UILIn 1 vnu ................... _. ... .. _.__.. STARTING DATE/ PROPOSED COMPLETION DATE 1Y262019 7�2019 FACILRY NAME EXISTING FACILITY PERMIT # FaeVip 4641 FACILRY ADDRESS CIIT ZIP CODE 1200 Coffee Road Bakemfieltl 93308 1. OF BUSINESS ANN # GDF TANK OWNER PHONE # Jamieson HIII (661) 393 -7000 ADDRESS C[tt ZIP CODE PO Box 82515 BakMafield OWN CONTRACTOR CA LICENSE ICE# CiOn9dence UST Services, Inc. 804904 84144 >fi -UT ADDRESS Cm ZIP CODE 93314 16250 Meacham Road Bakersfield PHONE # BAKERSFIELD CITY BDSIHESS LICENSE W00.KMANS COMP# INSURER 661-631 -3870 32864 1308371 SCIF BRIEFLY DESCRIBE THE WORK TO BE DONE: -T 1 M 51t� -I WATER To FACILITY PROVIDED BY DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT $FIE A OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR NEL? SPILLPREVENTION CONTROL AND COUNTERMEASURES PLAN ON FllE7 rl YES NO YES NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION TANKY V ME UNLEADED REGULAR PREARM DO'SEL THEIR 12000 X X Tank Testing Company NAME OF TESTING COMPANY FMONE NUMBER 661 631 -3870 Confidence UST Services Inc. - MAEUNG ADDRESS 16250 Meacham Road Bakersfield CA 93314 NAME OF TESTER ICCO 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 TEETER ICCR 8414476 -tn eha Tim Cap n Tim THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY F0E0a6 (Rev OB /09)