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Home My WebLink AboutMINOR MOD APP 9.30.19STARTING CATS/ ]I28I2019 PROPOSED COMPLETION DATE ]/2fi119 BAKERSFIELD FIRE DEPARTMENT UNDERGROUND STORAGE TANK ,AR Prevention Services ZIP CODE 93304 TYPE OF BUSINESS CUE 2101 H Street PERMIT APPLICATION P Bakersfield, CA 93301 TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW /IfI A�rr r Phone: 661- 326 -3979 • Fax: 661 -852 -2171 TANK INSTALL (EXISTING FACILITYVMOD -MINOR MOD ICC W74994UT Page 1 Of 1 ermit # ZIP CODE 93314 PHONEY I 661 - 631 -3870 BAKERSFIELD COYBUSINESS LICENSE i WORKMANS 32864 COMP# 1308371 INSURER SCIF BRIEFLY DESCRIBE THE WORK TO BE DONE: TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY ❑ NEW TANK INSTALL/EXISTING FACILITY v1 M MDrin UrATInN nF Earn TTV fil MINOR MODIFICATION OF FACILITY STARTING CATS/ ]I28I2019 PROPOSED COMPLETION DATE ]/2fi119 FACIUTr NAME fASTRIP #633 EXISTING FACDUTY PERMIT 4 FACILOYADDRESS CIIT 8001 South H Street =MRfieM ZIP CODE 93304 TYPE OF BUSINESS CUE APN F TANK OWNER Jeco Hill PHONE # 881x947000 ADDRESS Cm` P.O. Box 82515 BakenfeRl 21P CODE 933842515 CONTRACTOR Confidence UST Services Inc. CA LICENSE # 804904 ICC W74994UT ADDRESS 16250 Meacham Road " Bakersfield ZIP CODE 93314 PHONEY I 661 - 631 -3870 BAKERSFIELD COYBUSINESS LICENSE i WORKMANS 32864 COMP# 1308371 INSURER SCIF BRIEFLY DESCRIBE THE WORK TO BE DONE: MN I - WATER TD FACgUMf PROVIDED BY DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SUE I OF TANKS TO BE INSTALLED ARE THEY FOR MOTR FUEL? YES NO SPILLPREVENTION CONTROL AND COUNTERMEASURES PLAN ON RE? YES Fl NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION TANRY VOLUME UNLEADED REEULAR PREMIUM DIESIL OTHER 7 12000 X X Tank Testing Company NAME OF TESrBN COMPANY Confidence UST Services Inc. PHONE NUMBER 661 -631 -3870 PROLONG ADORESs 16250 Meacham Road Bakersfield CA 93314 NAME OF TESTER WCR 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 Frank Amestoy IV ICOY 8374998 -UT THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED I APPROVED BY