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., BAKERSFIELD FIRE DEPART!IIIT
_ EHVIROHIDH'l'AL SBRVI~
171S Chester Ave.,
BaJcersfield,CA 93301
(805) 326-3979
TANK RDOVAL INSPECTION PORM
FACILITY ~. if~ L ADDRESS 4 (X) , W (~IG 0."
OWNER~rll \ èo. PERMIT TO OPERATE' t~ - Od ),c)
CONTRAC'1'OR $oll<; 1=~!~~('('t'tv..'( .í:~(' 'CONTACT PERSON ß.¡t, &r-
LABORATORY PM!tLV-L ___tj. # OF SAMPLES .2.
TEST METHODOLOGY
PRELIMANARY ASSESSMENT CO.~~ e"'f't.. CONTACT PERSON JJllb f4,,.1r.1r
CO2 RECIEPT ..3(\ tht f7.NuJ(n LEL', 8- O2' ~
PLOT PLAN
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CONDITION OF TANKS <?f*I"JA{'(
CONDITION OF PIPING
CONDITION OF,SOIL
COMMENTS
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CITY OF BAKEmrFIELD7d if ~l)l4e:13{ ,
OFFICE OF ENVIRONMENTAL SERVICES I
1715 Chester A ve~, Bakersfield, CA (805) 326-3979
05/10/00 11:29
{1"
PERMIT APPLICATION FOR
REMOVAL OF AN UNDERGROUND STORAGE TANK
SITE INFORMATION
SITE NW Corner Wi hl "'" /Wh i t-~DDRESS 4001 Wible Rd. ZIP COD693309 APN 403-012-42
FACILITY NAME NA' CROSS STREET klhj.. te L¡:me
TANKOWNERJOPERATOR Fran Mar Co. PHONE NO. 661-325-1567
MAILING ADDRESS P.O. Box 9116 CITY Bakeq;field, CA. ZIP 93389
CONTRA(,'OR INFORMATION
COMPANY Soils Engineering,
ADDRESS 4400 Yeager Way
INSURANCE CARRIER state Fund
Inc. PHONE NO. 661-831-5100 LICENSE NO. 659286
CITY Bakersfi "",1 n r"A ZIP 93313
WORKMENS COMP NO.' '541 - 006
PRELIMINARY ASSESSMENT INFORMATION
COMPANY Soils Engineerinq. In.cPHONENO. 831-51 00 LJCENSENO. h5Q?Rh
ADDRESS 4400 Yeaqer Way CTIY Ra)<erRfi eId r ('"A , ZIP 93313
INSURANCE CARRlER state Fund WORKMENS COMP NO. 541-006
TANK CLEANING INFORMATION
COMPANY Foss Rmriro'1mental PHONE NO. hh1-~?? A174
ADDRESS 1 h?O~.Brl1nn;::¡IJ"'" T.;::¡np CITY Bakersf,ieldr CA. ZIP -93307
WASTE TRANSPORTER IDENil,FICATIONNU!v1BER CAD 0826QQ5h?'
NAME OF RINSATE DISPOSAL FACILlTI' Croshy /I" Overton
ADDRESS 1630 W. 17th CITY T,nnlJ H"",;::¡("'h, ('"A ZIPgOA1<
FACILITY IDENTlflCA TTON NUl'v1BER f"A f) 'O? R 4 n q n J q
, TANK TRANSPORTER INFORMATION
COMPANY Si9rrà Metal£
ADDRESS 162Q E. Brundage Lane
TANK DESTINATION Sierra Rpr.yr.1 i ng
PHONE NO. 327-7073 LICENSE NO. 770603
CITY R ñ k erR f i p 1 n, ('"A ZIP 9 3 3 0 7
TANK INFORMATION
TANK NO.
--.:1--
AGE
30+
CHEMLCAL
VOLUMË STORED
2500 to3000ry DiQsel
DATES
STORED
CHEMICAL
PREVTOUSL Y STORED
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For Ot1ici:l1 lJ.'IC Only
APPU~AI,U;.N DATi: ',.., ": ' ': ; ',' -::,:;;:< <~Yit¥ÁrnJ:'@f.~~º-j;;:::~·:,::;:::;~::~::)::,:¡+::¡::;:::i:~Q~:;ØF::.rÅ~K..t:~~:~:· '.' ".: ~ '::,f.tk'~8
Till:. Mi'LICAN'/' IIA8 RECEIVED. lJNL)ERSTANDS, AND Wll..L_()MI)I.Y WlTII HIE ATrACIif:D CONDITIONS Of' TlflS
1'1:!{MtT ANI> ANY <HilER STAI E, I.OCAL AND FEDERAL REGULAT10NS.
TillS FORM I Wi BEEN COMPLETED UNDERPf::NALTY OF PERJURY. AND TO TIΠBEST OF MY KNOWLEDGE IS TRlIE
ANI)('OI<H'·· Robevr ßec.kev ~~
APPLlCANT NAME (PRINT) APPLlC r SrGNA 11JRE
THISAPPLlCATION BECOME A PERMIT WHEN APPROVED
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Slight Depression
3400 Whne Lane
4001 Wible
WHl7ELANE
Pea E SERVICE
CENTER
LEGEND
. Soil Sample
n Investigation Trenches
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Approx. Scale
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SOILS ENGINEERING, INe.
4400 Yeager Way NW CORNER OF wml"E ROAD & WHITE LANE
Balœrsf'aeld, CA 93313 Bakersfid~, California
(661) 831- 5100
DATE: 412001 PLOT PLAN
PROJECT: 01-9600 "
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