HomeMy WebLinkAboutMINOR MOD APP 11.8.19UNDERGROUND STORAGE TANK 40-0101N PERMIT APPLICATION ��
TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW v
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD
Permit #
TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY ❑
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BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 - 326 -3979 . Fax: 661- 852 -2171
Page 1 of I
NEW TANK INSTALVEXISTING FACILITY
STARTING DATE/
PROPOSED COMPLEr10N GATE V
FACILITY NAME 7 -11 #32241
EXISTING FACILITY PERMIT #
FACILRy AOORE55
CalloWall
CITY
Bakersfield
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TYPE OF BUSINESS
Fuel Facility
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TANK OWNER
PHONE e
ADDRESS
CITY
ZIP CWE
CONTRACTOR BSSR Inc.
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1« "5257282
ADDRE55 6630 Rosedale H . #B
"�akersfield
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PFKNtlEM 661 588 -2777
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BRIEFLY DESCRIBE THE WORKTO BE DOME.
Replace 91 fill spill bucket per test fail
WATER TO FACILITY PROVIDED BY
DEPTH TO GROUND WATER
SOIL TYPE EXPECTED AT SITE
u OF TANKS TO BE INSTALLED
ARE THEY FOR FpiOR FUEL'
O TES IT NO
WI LL PREVENTION CCMROL AND COUNTERMEASURES PLAN QV FlLEi
O TES O NO
THIS SECTION I5 FOR STORAGE TANK IDENTIFICATION
TANKY
VOLUME
UNLEADED
RE.ULAR
PREMIUM
OIISFL
OTHER
Tank Testing Company
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Np[1jlg AsTSNGC COMPANY T91"998-2777
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MAILOUR
6630 Rosedale Hwy. #B
NAME del
Carrillo
ID5257282
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
Fidel Carrillo
ICCC
5257282
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED I
APPRWED BY
02006 (Rev 11 /2015)