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Home My WebLink About2012 FOLDERHOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTHOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. I - /d6110/=' File Number: S0 dSC4 Address: ?30C L Bakersfield, CA 933 Date Received: Business Name: 1 <-e-S 7e6cl e"es Lich,` SYSTEM: BUILDING SQUARE FEET: INSPECTION LOG New Mod. minor modification removal Commercial Hood System Fire Alarm System Fire Sprinkler System Spray Finish System Aboveground Storage Tank Underground Storage Tank 7 nderground Storage Tank Underground Storage Tank Other: Comments: Building Sq. Feet: Calculation Bldg. Sq. Ft: Date Time Signature BAKERSFIELD FIRE DEPARTMENT UNDERGROUND STORAGE TANK IN Prevention Services 1501 Truxtun Avenue, 1st Floor PERMIT APPLICATION D akersfield CA 93301 TO- CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW Rr r Phone: 661326 -3979 • Fax: 661 - 852 -2171rTANK'INSTALL (EXISTING FACILITY) /MOD -MINOR MOD Page i of 1 Permit # TYPE OF APPLICATION: NEW TANK INSTALL/NEW FACILITY NEW TANK INSTALL/EXISTING FACILITY CHECK ONE ONLY MODIFICATION OF FACILITY MINOR MODIFICATION OF FACILITY STARTING DATE/ PROPOSED COMPLETION DATE FACILITY NAME EXISTING FACILITY PERMIT # FACILITY ADDRESS ZIP CODE6C) 0 ra re_ eYS . X3301TYPEOFBUSINESSAPN # TANK OWNER . PHONE # ADDRESS CODEElees33 c 7NTRACIOCA, LICENSE. ICC # ADDRESS - ° _ S o bZ - T ZIP C D PHO "' BAKERSFIB D CITY BUSINESS LICENSE # WORKMANS COMP # INSURER' WREtLY. DESCRIBE THE WORK TO BE DONE: wAT& TO FACILITY PROVIDED Y 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? YES NO YES NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION TANK'# VOLUME UNLEADED REGULAR PREMIUM DIESELP _ OTHER ank Testing Company NAME OF TESTING COMPANY r R\C PHONE NUMBER MAILING,ADDRESS I NAME OF TESTER ICC# k 0IIII Uto -u7 THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THISPERMITANDANYOTHERSTATE, LOCAL, AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDERPENALTYOFPERJURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT. NAME OFTESTER ICC# THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY APPRODATEAPPROVED FD2086 (Rev 08/09) i#JNDERGROUND STORAGE TANK i PERMIT APPLICATION TO CONSTRUCT-INSTALL NEW TANK (NEW FACILITY)/NEW TANK INSTALL (EXISTING FACILITY)/MOD-MINOR MOD Permit # BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Avenue, 1st Floor Bakersfield, CA 93301 Phone.- 661-326-3979 • Fax: 661-852-2171 4410 Page 1 of 1 TYPE OF APPLICATION: NEW TANK INSTALL/NEW FACILITY NEW TANK INSTALL/EXISTING FACILITY CHECK ONE ONLY MODIFICATION OF FACILITY MINOR MODIFICATION OF FACILITY STARTING DATE/ PROPOSED COMPLETION . . . DATE FACILITY NAME EXISTING FACILITY PERMIT # FACILITY ADDRESS ZIP CODEcjo_ TYPE OF BUSINESS--,--) I , I-\ 'e- APN # ITANK OWNER r7; \ k'f\Acr I PHONE # - 9'hSD ADDRESS crpc--, 40 c-Q) ZIP CODE uo 6 CONTRALTO I V 0 Icc # 5"W ONADDRESS b 21P CODE PHO RSFIELD CITY BU NESS LICENSE ICA ORKMANS COMP # 0 INSURER._ BRIEFLY DESCRIBE THE WORK TO BE DONE: TO FACILITY PROVIDED DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE e\ I PHONE NUMBER RICH ENVIRONMENTAL SERVICE STATION oi., 15643BROOKSCTBAKERSFiELD, CA 93308-3708 PAY TO THE ORDER OF a CHAS EOJPMorganChaseBank, N.A. Ch'se.com 0RA 5) Q), 11)C\_ 1, k- 11 11161, 1.32227 I6 2 1139 L4 it, Z_ I 1-1112DATE3222 44841 V1010 DOLLARS 19 2 2 ?OR NP 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: o,•J p,i,. L„'& JOB DESCRIPTION: 'yV[ `r-c.v` OCCUPANCY TYPE: DWNER: ( ' d PERMIT NO. !S CONTRACTOR: c `PHONE # L, - %J"% FD 1743