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Home My WebLink AboutMINOR MOD APPP 7.29.19BAKERSFIELD FIRE DEPARTMENT UNDERGROUND STORAGE �R Prevention Services COMPLETION DATE 07IZBPAI9 ]I28119 2101 H Street PERMIT APPLICATION P fARTEN Bakersfield, CA 93301 TO CONSTRUCT - INSTALL NEW TANK (NEW F f f Phone: 661 - 326 -3979 R Fax: 661 -852 -2171 TANK INSTALL (EXISTING FACILITY) /MOD - 3701 Ming Avenue Page 1 of 1 Permit_ #.,,_, _ J TYPE OF BUSINESS APO 8 TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY ❑ NEW TANK INSTALL/EXISTING FACILITY M M mnrETTnRI nP FArTI m P1 MINOR MODIFICATION OF FACILITY V STARTING DATE/ PROPOSED COMPLETION DATE 07IZBPAI9 ]I28119 FACIUTY NAME EXISTING FACRL PERMIT Fasidp Kit MCILT' ADDRESS C[iY ZIP CODE 3701 Ming Avenue Bakersfield 93309 TYPE OF BUSINESS APO 8 GDF TANK OWNER PHONE b 861- 393 -]090 Jamieson Hill ADDRESS CITY Bakersfield ZIP CODE 93380 -2515 P.O. Box 82515 CONTRACTOR CA LICENSE 8 804904 ICC Y Confidence UST Services Inc. ADDRESS 16250 Meacham Road CIT" Bakersfield ZIP CODE 93314 PHONE d BAKERSFIELD CM BUSINESS UCENSE 8 - ORPHANS COMP 8 1308371 INSURER SCIF 661 - 631 -3870 2864 BRIERY DESCRIBE THE WORK TO BE DONE: B1E l - CM W o WATER TO FACILITY PROWDED BY DEPTH TO GROUND WATER SOILTYPE EXPERED AT SRE 8 OF TANKS TO BE INSTALLED ARETHEYFORMOTO FUEL SPILLPREVERRON CONTROL AND COUNTERMEASURES MAN ON FILE! YES NO YES NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION TANKS VOLUME UNLEADED RRGVLAR PREMIUM D]FSEL OTHER 2 12000 X X Tank Testing Company "" OF I"' COMPANY Confidence UST Services Inc. MIONI HUNGER 661 - 631 -3870 MA]LING ADORF95 16250 Meacham Road Bakersfield, CA 93314 NAME OF TESTER ICCR 8022804 -UT Bryan Self 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 PERIURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT. NAME OF TESTER ISO. 8022804 -UT Bryan Self THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY GATE APPROVED APPROVED BY FDZO86 (R¢v OB /O9)