HomeMy WebLinkAboutOPI Application 2-24-22UNDERGROUND STORAGE TANK
411",_
PEkM IT APPLICATION
TO CONSTRUCT -INSTALL NEW TANK (NEW FACILITY)/NEW
TANK INSTALL (EXISTING FACILITY)/MOD-MINOR MOD
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iPermit #
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BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 9 Fax: 661-852-2171
Page 1 of 1
TYPE OF APPLICATION: FINEW TANK INSTALL/NEW FACILITY F] NEW TANK INSTALL/ EXISTING FACILITY
1(_UE__r_V n1\1F_ nN11 V\ M mr)r)TPT(-ATTnru np Par -Tl TTY Fv/� M T N nRmnr)TFTC-ATTnN OF FACILITY
STARTING DATE/ 2/25/22 PROPOSED
COMPLETION DATE 2/26/22
FACILITY NAME White Ln. Chevron
EXISTING FACILITY PERMIT #
FACILITY ADDRESS
CITY Bakersfield
ZIP CODE
TYPE OF BUSINES s GDF
APN #
TANK OWNER
S
PHONE #
ADDRESS 2525 White Ln.
CITY Bakersfield
ZIP CODE
CONTRACTOR
Kern Construction
CA LICENSE #
'CC *5242369
ADDRESS
PO Box 6096
c' Bakersfield
ZIP CODE
93386
PHONE
#661-634-9950
BAKERSFIELD CITY BUSINESS LICENSE #
On File
WORKMANS COMP
#On File
INSURER State Fund
BRIEFLY DESCRIBE THE WORK TO BE DONE:
Install Drop Tube
WATER TO FACILITY PROVIDED BY
DEPTH TO GROUND WATER
SOIL TYPE EXPECTED AT SITE
# OF TANKS TO BE INSTALLED
RE THEY FOR MOTOR FUEL?
YES F-1 NO
SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
YES El NO
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
TANK VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER
Tank Testing Company
NAME OF TESTING COMPANY Kern Construction
PHONE NUMBER 661-634-9950
MAILING ADDRESS
NAME OF TESTER Josh Simmons
"cco 5242369
THE APPLICANT HAS RECEIVED, UNDERSTANDSr 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 PERJURYr AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT.
NAME OF TESTER ICC#
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED
APPROVED BY