HomeMy WebLinkAboutminor mod Permit 8-26-21BAKERSFIELD FIRE DEPARTMENT
UNDERGROUND STORAGE TANK Prevention Services
am 2101 H Street
PERMIT APPLICATION -0 Bakersfield, CA 93301
TO CONSTRUCT -INSTALL NEW TANK (NEW FACILITY)JNEW
V4 j �' Phone: 661-326-3979 •Fax. 661-852-2171
TANK INSTALL (EXISTING FACILITY)/MOD-MINOR MOD
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Permit #
TYPE OF APPLICATION: FINEW TANK INSTALL/NEW FACILITY F] NEW TANK INSTALL/EXISTING FACILITY
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STARTING DATE/ 08/02/2021
PROPOSED COMPLETION DATE 08/02/2021
FACILITY NAME Jaco #7776 Howards Market
EXISTING FACILITY PERMIT #
FACILITY ADDRESS 3300 Planz Road
CITY Bakersfield
ZIP CODE 93309
TYPE OF BUSINESS GDF
APN #
TANK OWNER Jamieson Hill
PHONE # 661-393-7000
ADDRESS P.O. BOX 82515
CITY Bakersfield
ZIP CODE 93380-2515
CONTRACTOR Confidence UST Services Inc.
CA LICENSE #
804904
ICC # 9482314
ADDRESS 2209 Zeus Court
CITY Bakersfield
ZIP CODE 93308
PHONE#
� 1 -�� -3870
661-631-3870
BAKERSFIELD CITY BUSINESS LICENSE #
32864
WORKMANS COMP # 1308371
INSURER State Fund
BRIEFLY DESCRIBE THE WORK TO BE DONE:
Replace all 3 drop tubes with new (MN Defender 708591902).
WATER TO FACILITY PROVIDED BY
DEPTH TO GROUND WATER
SOIL TYPE EXPECTED AT SITE
# OF TANKS TO BE INSTALLED
ARE THEY FOR MOTOR FUEL?
YES NO
SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
1:3YES ❑ NO
THIS SECTION IS FOR STORAGF TANK IDFNTTFICATIOKm
TANK #
VOLUME
UNLEADED
REGULAR
PREMIUM
DIESEL
OTHER
1
12K
X
X
2
12K
X
X
3
12K
X
Tank Testing Company
NAME OF TESTING COMPANY PHONE NUMBER
MAILING ADDRESS
NAME OF TESTER ICC#
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#
Ron Clark 9482314
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED APPROVED BY
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