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HomeMy WebLinkAboutApplication Minor Mod 3-30-21UNDERGROUND STORAGE TANK . .. .. .... . . . ... .. PERMIT APPLICATION TO CONSTRUCT -INSTALL NEW TANK (NEW FACILITY)/NEW TANK INSTALL (EXISTING FACILITY)/MOD-MINOR MOD 1Permit # Page 1 of 1 TYPE OF APPLICATION: 0 NEW TANK INSTALL/NEW FACILITY 0 NEW TANK INSTALL/EXISTING FACILITY fif If -10-1z ^ft1r_ rNK11 %/*% M K.4nnTCTf"A-rTnr%1 rl� 1=ArTI T-rV rO MTKI()P MOr)TFTCATTnN OF FACTI TTY STARTING DATE/ ASAP BAKERSFIELD FIRE DEPARTMENT FACILITY NAME ARCO Brundage & H Prevention Services FACILITY ADDRESS 1701 Brundage Lane 2101 H Street ZIP CODE 93304 Bakersfield, CA 93301 APN # Phone: 661-326-3979 • Fax: 661-852-2171 Page 1 of 1 TYPE OF APPLICATION: 0 NEW TANK INSTALL/NEW FACILITY 0 NEW TANK INSTALL/EXISTING FACILITY fif If -10-1z ^ft1r_ rNK11 %/*% M K.4nnTCTf"A-rTnr%1 rl� 1=ArTI T-rV rO MTKI()P MOr)TFTCATTnN OF FACTI TTY STARTING DATE/ ASAP PROPOSED COMPLETION DATE FACILITY NAME ARCO Brundage & H EXISTING FACILITY PERMIT # FACILITY ADDRESS 1701 Brundage Lane CITY Bakersfield ZIP CODE 93304 TYPE OF BUSINESS Gas Station APN # TANK OWNER Bisla Enterprises Inc PHONE # (661) 322-7213 ADDRESS 1701 Brundage Lane cI_1y Bakersfield ZIP CODE 93304 CONTRACTOR Advanced Compliance CA LICENSE #971259 IGC #8032698 ADDRESS 4007 Brae Burn Dr CITY Bakersfield ZIP CODE 93306 PHONE # (6 61 ) 706-4321 BAKERSFIELD CITY BUSINESS LICENSE # WORKMANS COMP # INSURER BRIEFLY DESCRIBE THE WORK TO BE DONE: Replace 87S & 87N LLD WATER TO FACILITY PROVIDED BY DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE # OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL? 0 YES 0 NO SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? 0 YES 0 NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER Tank Testing Company NAME OF TESTING COMPANY Advanced Compliance PHONE NUMBER (6 61) 706-4321 MAILING ADDRESS 4007 Brae Burn Dr Bakersfield, Ca. 93306 NAME OF TESTER Bruce Hinsley 'cc# 8032698 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 ICC# THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY