HomeMy WebLinkAbout2012 FOLDERHOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTHOOTH AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
Z ::: C9c7C d
File Number:
Date Received:
Address: /)(n / &i%L) e_ L j
Bakersfield, CA 933
Business Name:
Other: ,Z "4 C--
Comments:
1.
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3.
4.
INSPECTION LOG
Data Timm
A
Signature
Sighatuim
SYSTEM: BUILDING SQUARE FEET:
New Mod.
Commercial Hood System Building Sq. Feet:
Fire Alarm System Calculation Bldg. Sq. Ft:
Fire Sprinkler System
Spray Finish System
Aboveground Storage Tank
Underground Storage Tank
minor
modification Underground Storage Tank
removal Underground Storage Tank
Other: ,Z "4 C--
Comments:
1.
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3.
4.
INSPECTION LOG
Data Timm
A
Signature
Sighatuim
UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD /LINE TESTING/
SB989 SECONDARY CONTAINMENT
TESTING/TANK TIGHTNESS TEST AND
FUEL MONITORING CERTIFICATION
Please note that these are separate
individual tests and will be charged per
separate type test accordingly.)
PERMIT #
ENHANCED LEAK DETECTION
TANK TIGHTNESS
B A 7-
14
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 • Fax: 661-852-2171
Page 1 of 1
LINE TESTING SB -989 SECONDARY CONTAINMENT
FUEL MONITORING CERTIFICATION
SITE INFORMATION
FACILITY D14
NAM PHO # 0 CONTACT PERSON
ADDRESS
OWNER NAME •
y /
1
OPERATOR NAM / PERMIT TO OPERATE #
OF TANKS TO BE TESTED:
7
IS PIPING GOING TO BE TESTED? YES NO
TANK # VOLUME CONTENTS
7
3 7
TANK TESTING COMPANY
TESTING COMPANY / A NAME & ONE # 9F CO CT PERSON
s
MAILING ADDRESS
r 5
NAME & PH O E # F TE R OR SPECIAL IN ECTOR f
r S'1 /7tS'
CERTIFICATION #
DATE & TIME TEST TO BE CONDUCTED ICC # 52, TEST METHOD
APPLICANT GNATURE DATE
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED BY DATE —
XRArj( /yFD2095 (Rev 03/08)
CC # 5"S•z o 3 y v F/v°. / /vhy
SILUNG. & PERMIT STATEMENT t77aBAKERSFIELD FIRE DEPARTMENT
I D Prevention Services
PERMIT # Rrr ; 2101 H Street
Bakersfield, CA 93301Iftil'
my xffnl% m 0-n e TT'v nF BAKERSFIELD. Thank vou. OFFICE US
11102307Li1• 1:2221, 2790: 002 0006L,L,ill
Underground Storage Tank (Installation /Inspection) NI 878 /tank o
Underground Storage Tank (Modification) MOD 878 /site
SITE INFORMATION
167 /site
LOCATION OF PROJECT r fA
Underground Storage Tank (Removal) TR 573 /tank
PROPERTY OWNER
84
STARTING DATE
96 /hr (2 hrs minimum) _ $192
COMPLETION DATE
82
NAME
Oil well (Installation, Inspection, or re- inspection) X 96 /hr
PROJECT NAME
82
Tent #
ADDRESS PHONE#
PROJECT ADDRESS
After -hours inspection fee 121 /hr (2 hrs minimum) _ $242
SFIE(_D STATECITYg4iCC -R CA ZIP CODE
Pyrotechnic (1 permit per event, plus an inspection fee of
96 /hr during business hours) PY
NOTE: After hours Pyrotechnic event inspection is @ $121 /hr
96 /hr + (5 hrs min standby fee /insp) _ $576
5 hrs min standby fee ins = 605
CONTRACTOR INFORMATION
Re- inspection /Follow -up Inspection 96 /hr
CONTRACTOR NAME
84
CA LI ENSGE # TYP OF LI NS EXPIRATI N DA PHONE #
Explosive Storage 266 84
Copying & File Research (File Research fee $50 /hr)
CONTRACTOR COMPANY NAME
84
FAX #
ADDRESS
84
CITY I ZIP CODE Q%
my xffnl% m 0-n e TT'v nF BAKERSFIELD. Thank vou. OFFICE US
11102307Li1• 1:2221, 2790: 002 0006L,L,ill
Underground Storage Tank (Installation /Inspection) NI 878 /tank o
Underground Storage Tank (Modification) MOD 878 /site 82
Underground Storage Tank (Minor Modification) MTM 167 /site 82
Underground Storage Tank (Removal) TR 573 /tank 84
Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot.
NOTE: $96 /hr for each type of test/per site /per UST system
if scheduled at the same time
96 /hr (2 hrs minimum) _ $192 82
even
Oil well (Installation, Inspection, or re- inspection) X 96 /hr 82
Tent # 96 /tent 84
After -hours inspection fee 121 /hr (2 hrs minimum) _ $242
Pyrotechnic (1 permit per event, plus an inspection fee of
96 /hr during business hours) PY
NOTE: After hours Pyrotechnic event inspection is @ $121 /hr
96 /hr + (5 hrs min standby fee /insp) _ $576
5 hrs min standby fee ins = 605
84
Re- inspection /Follow -up Inspection 96 /hr 84
Portable LPG (Propane): # of Cages? _ 96 /hr 84
Explosive Storage 266 84
Copying & File Research (File Research fee $50 /hr) 0.25 /page 84
Miscellaneous 84
BAKERSFIELD CITY FIRE DEPARTMENT -- INSPECTION RECORD
Post this Card at the Job Site and DO NOT Remove for Duration of Work
Inspection Request Phone No. (661) 326 -3979
UST NEW INSTALL
DESCRIPTION DATE SIGNATURE
BACKFILL
PRIMARY PIPE
SECONDARY PIPE
SECONDARY CONTAINMENT
SENSORS
AUTHORIZATION FOR FUEL
ELECTRICAL SEAK -OFF
TANK TESTING
UST REMOVAL
DESCRIPTION DATE SIGNATURE
AST NEW INSTALL
DESCRIPTION DATE SIGNATURE
MODIFICATIONS MINOR / MAJOR
AST REMOVAL
DESCRIPTION DATE SIGNATURE
EVR UPGRADE
PRIOR TO OPERATION OF ANY SYSTEM,
ALL UST AND /OR AST SYSTEMS SHALL BE
INSTALL, COMPLETE AND ACCEPTED BY
MISC. ACTIVITY THE BAKERSFIELD CITY FIRE DEPARTMENT.
FIRE DEPARTMENT (FINAL)
REMARKS:
BUILDING ADDRESS: /+V
JOB DESCRIPTION: OCCUPANCY TYPE:
OWNER: N PERMIT NO.
CONTRACTOR: n j , PHONE #
FD 1743