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Home My WebLink AboutApplication10-4-21�� BAKERSFIELD FIRE DEPARTMENT UNDERGROUND STORAGE TANK Prevention Services �r 2101 H Street PERMIT APPLICATIONBakersfield, 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: FINEW TANK INSTALL/NEW FACILITY F1 NEW TANK INSTALL/EXISTING FACILITY (CHKK_ONF nN1 v) [:] MODIFICATION OF FACILITY [Z]MINOR MODIFICATION OF FACILITY STARTING DATE/ 09/10/2021 PROPOSED COMPLETION DATE TBD FACILITY NAME ARCO AM PM EXISTING FACILITY PERMIT # FACILITY ADDRESS 4203 Ming Avenue CITY Bakersfield ZIP CODE 93309 TYPE OF BUSINESS GDF APN # TANK OWNER Grand Avenue Coast, Inc. PHONE # 510-861-0045 ADDRESS 4203 Ming Avenue CITY Bakersfield ZIP CODE 93309 CONTRACTOR Confidence UST Services, Inc. CA LICENSE # 804904_ ICC # 9482314 ADDRESS 2209 Zeus Court CITY Bakersfield ZIP CODE 93308 PHONE # 661-631-3870 BAKERSFIELD CITY BUSINESS LICENSE # 32864 WORKMANS COMP # 1308371 INSURER State Fund BRIEFLY DESCRIBE THE WORK TO BE DONE: Replace (3) drop tubes: 87-1, 87-2 & 91 (OPW PN 71 SO -410C) 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? C1 YES ❑ NO THIS SECTION IS FOR STORAGE TANK MENTIFICATION TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER 1 12K X X 2 12K X X 3 12K X X Tank I esting 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 Ron Clark ICC# 9482314 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY FD2086 (Rev 11/2015)