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Home My WebLink Aboutminor mod Application 7-22-21BAKERSFIELD FIRE DEPARTMENT UNDERGROUND STORAGE TANKPrevention Services i 1a 2101 H Street PERMIT APPLICATION Bakersfield, CA 93301 TO CONSTRUCT -INSTALL NEW TANK (NEW FACILITY)/NEW Phone: 661-326-3979 • Fax: 661-852-2171 TANK INSTALL (EXISTING FACILITY)/MOD-MINOR MOD Page 1 of 1 Permit # TYPE OF APPLICATION: NEW TANK INSTALL/NEW FACILITY F-1 NEW TANK INSTALL/EXISTING FACILITY CHECK ONE ONLY) [:] MODIFICATION OF FACILITY EZIMINOR MODIFICATION OF FACILITY STARTING DATE/ 07/22/2021 PROPOSED COMPLETION DATE 07/22/2021 FACILITY NAME Avo's Shell EXISTING FACILITY PERMIT # FACILITY ADDRESS 5700 Auburn Street CITY Bakersfield ZIP CODE 93307 TYPE OF BUSINESS GDF APN # TANK OWNER Avo s s RHONE # 661-366-5542 ADDRESS 8101 Edison Highway CITY Bakersfield ZIP CODE 93307 CONTRACTOR Confidence UST Services, Inc. CA LICENSE # Q80 904 ICC # 9482314 ADDRESS 2209 Zeus Court CITY Bakersfield ZIP CODE 93308 PHONE # 661-631-3870 BAKERSFIELD CITY BUSINESS LICENSE # WORKMANS COMP # 1308371 INSURER State Fund BRIEFLY DESCRIBE THE WORK TO BE DONE: Replace speaker for audio/visual of over alarm. WATER TO FACILITY PROVIDED BY DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL? SPILL YES NO PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? YES NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION 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 Aaron Perrigo ICC# 8485827 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY FD2086 (Rev 11/2015)