HomeMy WebLinkAboutOPI Application 2-24-22UNDERGROUND STORAGE TANK
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
MM,
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
emit #
TYPE OF APPLICATION: NEW TANK INSTALL/NEW
FACILITY NEW TANK INSTALL/EXISTING FACILITY
(CHECK ONE ONLY MODIFICATION OF FACILITY MINOR MODIFICATION OF FACILITY
STARTING DATE/ 2/25/22
PROPOSMtOMPLEtI614 D A-1 26/22_1'-
FACILITY NAME Samco #2
PERMIT #
FACILITY ADDRESS 3300 White Ln.
'y Bakersfield
ZIP COD
TYPE OF BUSINESS GDF
APN #
TANK OWNER Samco Food Stores
PHONE #
ADDRESS 3300 White Ln,
Bakersfield
ZIP CODE
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LICENSE 0
ICC
-4 .6
Tank Testing Company
NAME OF TESTING COMPANY Kern Construction PHONE NUMBER 661-634-9950
MAILING ADDRESS
NAME OF TESTERICC# 5242369
Josh Simmons
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 I ICC#
FOR OFFICIAL USE ONLY
D:
FD2086 (Rev 11/2015)