HomeMy WebLinkAboutMINOR APP 9.26.19STARTING DATE/ 09/16/2019
BAKERSFIELD FIRE DEPARTMENT
UNDERGROUND STORAGE TANK
EXISTING FACILITY REPORT A
Prevention Services
�Bakersfield
4•,
2101 H Street
PERMIT APPLICATION
TANK OWNER Jamieson HIII
Bakersfield, CA 93301
TO CONSTRUCT - INSTALL NEW TANK (NEW FACILITY) /NEW
cr" Bakersfield
Phone: 661 - 326 -3979. Fax: 661 -852 -2171
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD
uUCENSE *60491
Page 1 of 1
(Permit #
°1Y Bakersfield
ZIP CODE 93314
TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY ❑
NEW TANK INSTALL/EXISTING FACILITY
/rHFr( nNF nNi YI n MODIFICATION OF FACILITY )EI
MINOR MODIFICATION OF FACILITY
STARTING DATE/ 09/16/2019
PROPOSED COMPLETION DATE 09/16/2019
FACILITY NAME Fastrip #6
EXISTING FACILITY REPORT A
FA` N' TY ADDRESS 1640 South Chester Avenue
�Bakersfield
ZIP CODE 93304
TYPE OF BUSINESS GDF
APE N
TANK OWNER Jamieson HIII
PHONE #66.1 -393 -7000
ADDRESS PO Box 82515
cr" Bakersfield
I 'IP CODE 93380 -251
CONTRACroRConfidence UST Services, Inc.
uUCENSE *60491
=cc. 8180171
ADDRESS 16250 Meacham Road
°1Y Bakersfield
ZIP CODE 93314
PHONE *661- 631 -3670
B2X =FIELD Cm' OUSNESS LICENSE B
WORKMANS CORP .1308371 -2017
INSURER State Fun
BRIEFLY DESCRIBE THE WORK TO BE DONE:
Replace Veeder -Root annular sensor PN 794390 -420 on the diesel tank.
WATER TO FACILITY PROVIDED BY
DEPTH TO GROUND WATER
SOILTYPE EXPECTED AT SUE
A OF TANKS TO BE INSTALLED
ARE THEY FOR MOTOR FUEL,
D YES . NO
SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
0 YES 0 NO
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
TANK.
VOLUME
UNWDED
RHiULAR
PREMIUM
DIESEL
OWNER
1 (87 Master)
12000
X
X
Tank Testing Company
MME OF TEBTMO GOMPANJLOntldence UST Services
PHONE NUMBER 661 -631 -3870
"A'L"MM"Meacham Road
NAME OF TESTER
Matt Story
«# 9118985
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
Matt Story
ICC.
9118985
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED
APPROVED BY