HomeMy WebLinkAboutOPI Application 7-29-22tf,aft,)6. BAKERSFIELD FIRE DEPARTMENT
UNDERGROUND STORAGE TANK Prevention Services
2101 H Street
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 2
Permit #
TYPE OF APPLICATION: F� NEW TANK INSTALL/NEW FACILITY F] NEW TANK INSTALL/EXISTING FACILITY
(CHECK ONE ONLY) n MODIFICATION OF FACILITY n MTNnR Mnr)TFTC'ATTnN nF PA(71 T7•v
- -
STARTING DATE/ ASAP
�� • • - • a a v I \ -lot
PROPOSED COMPLETION DATE TBD
FACILITY NAME Avo's Shell
EXISTING FACILITY PERMIT #
FACILITY ADDRESS 5700 Auburn Street
CITY Bakersfield
ZIP CODE 93307
TYPE OF BUSINESS GDF
TANK OWNER q vols
APN #
PHONE #661-366-5542
ADDRESS 5700 Auburn Street CITY Bakersfield
CONTRACTOR Nwestco, LLC C 6RC-1
ZIP CODE 93306
ICC # 9482314
ADDRESS 2209 Zeus Court
CITY Bakersfield
ZIP CODE 93308
PHONE #661-631-3870
BAKERSFIELD CITY BUSINESS LICENSE #
00166937
WORKMANS COMP #XWS57384241
INSURER Ohio
BRIEFLY DESCRIBE THE WORK TO BE DONE:
Replace Drop Tube on the 87, 91 and Diesel Tank
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 PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
17� YES � NO 0 YES NO
-F
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
TANK #
VOLUME UNLEADED REGULAR PREMIUM DIESEL !OTHER
1
12k x x
2
12k x X
3
X
Tank Testinq Companv
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 RonClark
ICC#
9482314
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED APPROVED BY
FD2086 (Rev 01/2022)