HomeMy WebLinkAboutFMC Application -2 5-3-22^� BAKERSFIELD FIRE DEPARTMENT
UNDERGROUND STORAGE TANK Prevention Services
2101 H Street
PERMIT APPLICATION ! Bakersfield, CA 93301
TO CONSTRUCT -INSTALL NEW TANK (NEW FACILITY)/NEWS Phone: 661-326-3979 • Fax: 661-852-2171
TANK INSTALL (EXISTING FACILITY)/MOD-MINOR MOD
Page 1 of 2
Permit #
TYPE OF APPLICATION: NEW TANK INSTALL/NEW FACILITY F] NEW TANK INSTALL/EXISTING FACILITY
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STARTING DATE/ No later than 5/31/2022
PROPOSED COMPLETION DATE Same day
FACILITY NAME
Costco Gasoline Loc. No. 688
EXISTING FACILITY PERMIT #
15-021-003276
FACILITY ADDRESS
3800 Rosedale..Highway
CITY
Bakersfield CA
ZIP CODE
93308
TYPE OF BUSINESS
Retail Fuelinq Facilit
APN #
TANK OWNER
Costco Wholesale
PHONE #
425-313-8100
ADDRESS
P.O. Box 35005
CITY
Seattle. WA
ZIP CODE
98124
CONTRACTOR CA LICENSE #
W.S.K. & Sons Inc. 888712
ICC
8882502
ADDRESS
34455 Sunlight Drive
CITY
Yucaipa, CA
ZIP CODE
92399
PHONE #
951-906-3022
BAKERSFIELD CITY BUSINESS LICENSE #
22 00108086 1
WORKMANS COMP #
WSWC285932
INSLRER
Acord
BRIEFLY DESCRIBE THE WORK TO BE DONE:
TLS Software Upgrade with ISD and Cold Start
WATER TO FACILITY PROVIC
DEPTH TO GROUND WATER _0T_
# OF TANKS TO BE INSTALL ilia Ejj�,;u NE
EXIV-jr
EL _ )L :R Q -_
111 %Nt] I -
THIS SECTION It FOR STORAGE TANK IDENTTF:TrATIOh_
TANK # VOLUME UNLEADED I REGULAR 1 PREMIUM I DIESEL 101
A� IL I%WE)U TtE INI(
I
Tank Testing Company
NAME OF TESTING COMPANY
Same as contractor info above
PHONE NUMBER
MAILING ADDRESS
NAME OF TESTER
ICC#
Bill Karras
8882502
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
ICC#
Bill Karras
8882502
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED
APPROVED BY
rULU00 (Kev Ul/LULL)