HomeMy WebLinkAboutUST-PERMIT COVERSHEET 9/24/2011HOODS ALARMS SPRINKLER SYSTEMS 9F ° " W o OO V H AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
File Number: 3 c, G
r //
Address: 7 4 S-
Bakersfield, CA 933
Date Received:
Business Name:
SYSTEM: BUILDING SQUARE FE F INSPECTM L ®2
New Mod.
Commercial Hood System Building Sq. Feet: Date Time
Fire Alarm System Calculation Bldg. Sq. Ft: aj„ N a
AbZ4M 'ji. _ Fire Sprinkler System Z.
Jl g // AO-C-57- vote N
E; ccl Gf, Sgf Pm; 3. Pesss res> c
Aboveground Storage Tank 4.
Underground Storage Tank
mi or Signature
modification nderground Storage Tank
removal Underground Storage Tank
Signature
Other.
Comments:
F
CONFIDENCE UST SERVICES, INC.
417 Montclair Street, Bakersfield, CA 93309 800-339.9930 or 661 -631 -3870
FINAL TEST RESULTS:
ALERT 1000 / ALERT 1050 / TEI LT -3
CUSTOMER ADDRESS: WORK ORDER:28186 SITE ADDRESS:
Sullivan Petroleum Co. Downtown Chevron
1000 Truxtun Avenue TEST DATE: 11/11/11 2317 L Street
Bakersfield, CA 93301 Bakersfield, CA 93301
SITE CONTACT:Frank Sullivan PHONE NUMBER: 661-327-5008
TECHNICIAN: Doug Young PHONE NUMBER:800- 339 -9930 LICENSE: 9010-76
WATER IN BACKFILL:n /a DATE 6 TIME OF LAST FUEL DELIVERY:n /a
TANK INFORMATION:
WETTED)
PRODUCT TYPE:
TOTAL GALLONS:
PRODUCT LEVEL:
PERCENT FULL-
TEST METHOD:
WATER IN TANK:
TANK MATERIAL:
P.S.I.@ BOTTOM:
TEST DURATION:
FINAL LEAK RATE:
TEST RESULT:
TANK INFORMATION:
ULLAGE)U /F ONLY
ULLAGE GALLONS:
START PRESSURE:
END PRESSURE:
TEST RESULT:
PRODUCT LINES:
LINE TYPE:
START TIME
END TIME:
TEST PRESSURE:
FINAL LEAK RATE:
TEST RESULT:
MECHANICAL
LEAK DETECTORS:
MODEL:
SERIAL NUMBER:
CHECK VALVE PSI:
BLEED OFF ml:
LEAK RATE TESTED:
TEST RESULT:
TANK 1 TANK 2 TANK 3 TANK 4
Regular Plus Super
ALERT 1050X ALERT 105OX ALERT 1050X ALERT 1050X
TEI LT -3 TEI LT -3 TEI LT -3 TEI LT -3
Pressure Pressure Pressure
4:40pm 4:40pm 4:40pm
4:55pm 4:55pm 4:55pm
50 psi 50 psi 50 psi
0.004 qph 0.003 gph 0.003 gph
PASS PASS PASS
Red Jacket FXT Red Jacket FXT Red Jacket FAT Red Jacket FXT
A) These systems and methods meet or exceed the criteria in USEPA 40CFR parts 280, NFPA 329 -87 and allapplic
y
to odes.
B) Any fai re- s ed above may require further action, check with all regulatorygury agencies.
Technicia a a re: Date. Manufacturer Cer tfication No:
r
an or
D glas m. Young III Alert: 2004040 TEI: LT-3,089
CONFIDENCE UST SERVICES, INC.
417 Moikelalr Street, Bakersfield, CA 83309 800-339 -8830 or 881 -6313870
FINAL TEST RESULTS:
ALERT 1000 / ALERT 1050 / TEI LT -3
CUSTOMER ADDRESS: WORK ORDER: 28200 SITE ADDRESS:
Sullivan Petroleum Co. Downtown Chevron North
1000 Truxton Ave. TEST DATE: Nov. 18, 2011 2317 LfStreetCA 93301Bakersfield, CA 93301
SITE CONTACT:Frank Sullivan PHONE NUMBER: 661-327-5008
TECHNICIAN: Doug Young PHONE NUMBER:800- 339 -9930 LICENSE:90 -1076
WATER IN BACKFILL:N /A DATE S TIME OF LAST FUEL DELIVERY:N /A
TANK INFORMATION:
WETTED)
PRODUCT TYPE:
TOTAL GALLONS:
PRODUCT LEVEL:
PERCENT FULL:
TEST METHOD:
WATER IN TANK:
TANK MATERIAL:
P.S.I.@ BOTTOM:
TEST DURATION:
FINAL LEAK RATE:
TEST RESULT:
TANK INFORMATION:
ULLAGE)U /F ONLY
ULLAGE GALLONS:
START PRESSURE:
END PRESSURE:
TEST RESULT:
PRODUCT LINES:
LINE TYPE:
START TIME:
END TIME:
TEST PRESSURE:
FINAL LEAK RATE:
TEST RESULT:
MECHANICAL
LEAK DETECTORS:
MODEL:
SERIAL NUMBER:
CHECK VALVE PSI:
BLEED OFF ml:
LEAK RATE TESTED:
TEST RESULT:
TANK 1 TANK 2 TANK 3 TANK 4
Regular Mid -Grade Premium Diesel
ALERT 1050X ALERT 105OX ALERT 105OX ALERT 105OX
TEI LT -3 TEI LT -3 TEI LT -3 TEI LT -3
Pressure Pressure Pressure Pressure
3:15pm 3:40pm 3:40pm 3:15pm
3:30pm 3:55pm 3:55pm 3:30pm
50 psi 50 psi 50 psi 50 psi
0.003 gph 0.004 gph 0.003 gph 0.005 gph
PASS PASS PASS PASS
Red Jacket FXT Red Jacket FXT Red Jacket FXT Red Jacket FXT
A) These syystems and methods meet or exceed the criteria in USEPA 40CFR parts 280, NFPA 329 -87 and all
applicab stat codes.
B) Any fa ur ed above may require further action, check with all regulatory agencies.
Technic' s ure: Date: Manufacturer Cer }fication No:
an or
uglas m. Young III (( Alert: 2004090 TEI : LT-3,089
UNDERGROUND STORAGE TANK
PERMIT APPLICATION
TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD
IPermit #
TYPE OF APPLICATION:
CHECK ONE ONLY)
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 - 326 -3979 • Fax: 661 - 852 -2171
AR r
Page 1 of 1
NEW TANK INSTALL/NEW FACILITY
MODIFICATION OF FACILITY
NEW TANK INSTALL/EXISTING FACILITY
it MINOR MODIFICATION OF FACILITY
ST RTINGqATE/
ctODer 15, 2011
PRO oS D MPLETI AT
UcVO e ,011
FACILITY NAME
Downtown Chevron - North side
EXISTING FACILITY PERMIT #
FYffff'WFE% Street -7cTakersfield 2933r61
TYPE OF BUSINESS
Gas Station
APN #
TANK OWNER
Sullivan Petroleum Co. LLC
PHONE #
661 - 327 -5008
A10 0 Truxtun Ave. akersfield zIP9 01
CONTRACTOR
Sunset Construction and Mechanical
CA LICENSE #
589517
IC
41013 44 9
AD r sls7 Kimber Ave. C
akersfield Z193307
PH # gZ1- 322 -0660 BAKERSFIE4D Crf1 BUSINESS LICENSE #
On File
W MP # n -10 INSURER
SCIF
BRIEFLY DESCRIBE THE WORK TO BE DONE: Pull new OPW Pisces piping through existing sleeve.
WATER TO FACILITY PROVIDED BY California Water
DEPTH TO GROUND WATER_ 1251 SOIL TYPE EXPECTED AT SITE Sand
OF TANKS TO-BEOne LLED
NN
ARE THEY FOR MOTOR FUEL?
IX YES NO EX
SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
YES NO
THXS SECTION IS FOR STORAGE TANK IIDIENTXFIICATIION
TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER
Tank Testing Company
NAME OF TESTING COMPANconfidence UST Services PHONE NUMBER
1- 800 - 339 -9930
MAILING ADDRESS
16250 Meacham Road Bakersfield, CA 93314
NAME OF TESTER
Doug Young I ICC# 901076
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
Doug Young
ICC#
901076
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
DATE APPROVED
C
APP VED Y
FD2086 (Rev 08/09)
UNDERGROUND STORAGE TANK
PERMIT APPLICATION
TO CONSTRUCT- INSTALL NEW TANK (NEW FACILITY) /NEW
TANK INSTALL (EXISTING FACILITY) /MOD -MINOR MOD
IPermit #
TYPE OF APPLICATION:
CHECK ONE ONLY
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
j Bakersfield, CA 93301
FIRE Phone: 661 - 326 -3979 o Fax: 661 - 852 -2171ARr' r
Page 1 of 1
NEW TANK INSTALL/NEW FACILITY NEW TANK INSTALL/EXISTING FACILITY
MODIFICATION OF FACILITY 9 MINOR MODIFICATION OF FACILITY
ST RTINGqp,TE/ CtOl er 15 , 2 011
PRO S D MPLETI AT
c o er , t2 011
FACILITY NAME
Downtown Chevron - South side
EXISTING FACILITY PERMIT #
FAGI4IIY Dg11ES Street Bakersfield Z1M33rb1
TYPE OF BUSINESS
Gas Station
APN #
TANK OWNER
Sullivan Petroleum Co. LLC
PHONE
661 - 327 -5008
ADDRE 5
10 0 akersfield ZIP93 01
CONTRACTOR
Sunset Construction and Mechanical
CA LICENSE #
589517
IC1541013449
AD4bl7 Kimber Ave. takersfield Z193307
9V-322-0660 BAKERSFIELD CITY BUSINESS LICENSE #
On File
W MP # 10 FINSFURER
IF
BRIEFLY DESCRIBE THE WORK TO BE DONE: Pull new OPW Pisces piping through existing sleeve.
WATER TO FACILITY PROVIDED BY California Water
DEPTH TO GROUND WATER_ 1251 SOIL TYPE EXPECTED AT SITE Sand
OF TANKS TO -BEOINSTALLED
j en
LLED ARE THEY FOR MOTOR FUEL?
K YES NO EX
SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE?
YES NO
THIS SECTION IS FOOD STORAGE TANK IIDEHTXFIICATIION
TANK i# VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER
Tank Testing Company
NAME OF TESTING COMPANconfidence UST Services PHONE NUMBER
1- 800 - 339 -9930
MAILING ADDRESS
16250 Meacham Road Bakersfield, CA 93314
NAME OF TESTER
Doug Young
ICCA 901076
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
Doug Young
ICC#
901076
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE
DATE APPROVED
j
APPRO D BY
FD2086 (Rev 08/09)
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