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Home My WebLink AboutMinor Mod 10-8-21_4-4^� BAKERSFIELD FIRE DEPARTMENT UNDERGROUND STORAGE TANK Prevention Services 2101 H Street PERMIT APPLICATION Bakersfield, CA 93301 TO COl�lSTR UCT-I�iST.4LL NEW TANK (NE�l�� FACILITY)/NElN 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 NEW TANK INSTALL/EXISTING FACILITY (CHECK ONE ONLY; ❑ MODIFICATION OF FACILITY D MINOR MODIFICATION OF FACILITY STARTING DATE/ 9/10/2021 PROPOSED COMPLETION DATE 10/10/2021 FACILITY NAME 7 -ELEVEN EXISTING FACILITY PERMIT # FACILITY ADDRESS 1900 UNION AVE CITY BAKERSFIELD ZIP CODE 93305 TYPE OF BUSINESS GASOLINE DISPENSING FACILITY APN # TANK OWNER 7 -ELEVEN PHONE # 661-343-4651 ADDRESS CITY ZIP CODE CONTRACTOR BSS R I N C , CA LICENSE # ILL # 5257282 ADDRESS 6630 ROSEDALE HWY ##B CITY BAKERSFIELD ZIP CODE 93308 PHONE # 661-588-2777 BAKERSFIELD CITY BUSINESS LICENSE # 18001 10752 WORKMANS COMP # �� INSURER ACE AMERICAN INS BRIEFLY DESCRIBE THE WORK TO BE DONE: MAKE REPAIRS TO DIESEL STP SUMP WALL, SAND/CLEAN AND FIBERGLASS AFFECTED AREA AS NEEDED, TEST STP SUMP AFTER REPAIRS 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 Mi DIESEL 0 T H E R 1 X 2 X 3 3 Tank Vesting Company N ME OF TESTING COMPANY BSSR INC, PHONE NUMBER 661-588-2777 MAILING ADDRESS NAME OF TESTER FlDEL C'`ARRII LO ICC# 6257282 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 TEST ER FIDEL CARRILLO ICC" 5257282 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY FD2086 (Rev 11/2015)