HomeMy WebLinkAboutMinor Mod Application 5-16-22BAKERSFIELD FIRE DEPARTMENT
UNDERGROUND STORAGE TANKPrevention Services
i:� 2101 H Street
PERMIT APPLICATION Bakersfield, CA 93301
TO CONSTRUCT -INSTALL NEW TANK (NEW FACILITY)/NEWA Phone: 661-326-3979 • Fax: 661-852-2171
TANK INSTALL (EXISTING FACILITY)/MOD-MINOR MOD Page 1 of 1
Permit # E
TYPE OF APPLICATION: F-1 NEW TANK INSTALL/NEW FACILITY F-1 NEW TANK INSTALL/EXISTING FACILITY
(CHECK ONE ONLY) F-1 m nr)TFT(-,ATTnN OF FA( -TI TTY n MTKInD mr)nTr:TrA--Tnni nP7 GArTI TTV
STARTING DATE/ 3/3/22
PROPOSED COMPLETION DATE 4/3/22
FACILITY NAME Grand Island Sullys
EXISTING FACILITY PERMIT #
FACILITY ADDRESS 11400 Ming Ave.
CITY Bakersfield
ZIP CODE
TYPE OF BUSINESS GDF
APN #
TANK OWNER Sullivan Petroleum
PHONE #
ADDRESS 1000 Truxtun Ave.
CITY Bakersfield
ZIP CODE
CONTRACTOR Kern Construction
CA LICENSE #
I
ICC #5242369
ADDRESS PO Box 6096
CITY 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:
Put caps on brine reservoirs. Repair J -Box.
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 F 1 NO
SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
YES EJ 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
ICC# 5242369
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#
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED
APPROVED BY
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