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Home My WebLink Aboutminor mod 9-14-21_3-4TYPE €1F APPLICATION: (CHECK ONE ONLY) BAKERSFIEL.D FIRE DEPARTMENT �~ Prevention Services 2101 H Street y Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661-852.2171 Page 1of1 FINEW TANK INSTALL/NEW FACILITY � NEW TANK INSTALL/EXISTING FACILITY [71 MODIFICATION OF FACILITY✓Q MINOR MODIFICATION OF FACILITY STARTING DATE/ 08/18/2021 PROPOSED COMPLETION DATE TBD FACILITY NAME Jaco #3380 Farrell's Fastrip EXISTING FACILITY PERMIT # FACILITY ADDRESS 6401 White Lane CITY Bakersfield ZIP CODE 93309 TYPE OF BUSINESS GDF APN # TANK OWNER taco Hill PHONE # 001-393-7000 ADDRESS P.O. Box 82515 CITY Bakersfield ZIP CODE 93380-2515 CONTRACTOR Confidence �� 11 , Inc.1 CA LICENSE # 804904 ICC # 9482314 ADDRESS 2209 Zeus Court CITY Bakersfield ZIP CODE 93308 PHONE # 001-631.3870AKERSFIELD CITY BUSINESS LICENSE # 32864 WORKMANS COMP # 1308371 INSURER State Fund BRIEFLY DESCRIBE THE WORK TO BE DONE: Replace all (3) Defender Series drop tubes (PN 708592902). 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? YES Q 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 PER3URY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT. NAME OF TESTER Ron Clark� ,. ICC# 9482314 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY FD2086 (Rev 11/2015)