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HomeMy WebLinkAboutUST-PLAN COVERSHEET 4/23/2012HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. File Number: _ 3-5760 Date Received: .</- z 3- / Z Other: Comments: Address: 444 0 Bakersfield, CA 933 Business Name: 2 L BUILDING SQUARE FEET: INSPECTION LOG Building Sq. Feet: Calculation Bldg. Sq. Ft: natp- Time Signature SYSTEM: New Mod. Commercial Hood System Fire Alarm System Fire Sprinkler System Spray Finish System Aboveground Storage Tank Underground Storage Tank minor modification Underground Storage Tank removal Underground -Storage Tank Other: Comments: Address: 444 0 Bakersfield, CA 933 Business Name: 2 L BUILDING SQUARE FEET: INSPECTION LOG Building Sq. Feet: Calculation Bldg. Sq. Ft: natp- Time Signature UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD / LINE TESTING SB989 SECONDARY CONTAINMENT TESTING TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. ENHANCED LEAK DETECTION TANK TIGHTNESS TEST LLrJINETESTING r r TO PERFORM FUEL MONITORING CERTIFICATION BAKERSFIELD FIRE DEPT. Prevention Services 21 L t it '' STET Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 Page 1 of 1 SB -989 SECONDARY CONTAINMENT TESTING INFORMATION 5 A FACILITY n - NAM &P N NUMBE OF C NTA P ON ADDRESS A U e 3 3 3C IJL Ti OWNERS NAME OPERATORS NAM F PERMIT TO OPERATE N0. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BET ED7 YES NO TANK # VOLJUM? CONTENTS lJ J LCD 2P TANKTESTING COMPANY M.'.. NAME OF TESTING COMPANY TanICnOIO InC. gy, NAME & PHONE NUMBER OF Deanna DavenportCONTACTPERSONp 800 - 666 -1130 MAILING ADDRESS 41785 Enterprise Circle S. Suit D Temecula, CA 92590 NAME & PHONE NUMBER OF ERTIFICATION #: TESTER OR SPECIAL INSPECTOR: _ DATE & TIME CONDUCTED; TES / v ICC #: c/L ( —Lt M TEST THO SIGNATURE OF APPLICANT DATE: Z APPROVED BY DATE rte TANKNOLOGY TESTING NOTIFICATION Southern California Regional Office 41785 Enterprise Circle South, Suite D Temecula, CA 92590 951 - 6764060 800 - 666 -2176 951 - 6764061 Facsimile TO: City of Bakersfield Fire Department TELECOPY NO. 661 - 852 -2171 FROM: Deanna Davenport DATE: 4/24/2012 Tanknology Corporate Headquarters 8501 North MoPac Expressway, Suite 400 Austin, TX 78759 512 - 451 -6334 800 - 800 -4633 512 - 459 -1459 Facsimile E -MAIL: www.ci.bakersfield.ca.us E -MAIL: E -MAIL: ddavenport(a)tanknology.com TIME: NO. OF PAGES INCLUDING COVER: 1 ORIGINAL TO FOLLOW: COMMENTS: Tanknology will be at the following locations: No Tanknology, Worldwide Leaders in UST Compliance Testing CONFIDENTIALITY NOTICE - This message is intended for the use of the individual or entity for which it is addressed and may contain information that is legally privileged, confidential, and exempt from disclosure. If the reader of this messaage is not the intended recipient, you are hereby notifiedthat any dissemination, distribution, or copying of this communication is strictly prohibited. If you received this communication in error, please notify us immediately by telephone to arrange for the return of the original material. DATE TIME SITE AND ADDRESS TEST TYPE 04/30/12 11:00am YRC, 4901 Lisa Marie Court, Bakersfield, CA 93313 661- 833 -1895 Please advise if test date and time is acceptable Check # 5533 Enclosed for $ 192.00 for testing Line Test ONLY Tanknology, Worldwide Leaders in UST Compliance Testing CONFIDENTIALITY NOTICE - This message is intended for the use of the individual or entity for which it is addressed and may contain information that is legally privileged, confidential, and exempt from disclosure. If the reader of this messaage is not the intended recipient, you are hereby notifiedthat any dissemination, distribution, or copying of this communication is strictly prohibited. If you received this communication in error, please notify us immediately by telephone to arrange for the return of the original material. 2 TANKNOLOGY -SO. CALIFORNIA PH. (951) 676 -4060 41785 ENTERPRISE CIR S, STE D TEMECULA, CA 925W Pay to the order of WELLS FAR60 BANK, N.A. (JCALIFORNIA WELLSFARGO.0OM For / II100 5 5 3 3111 1:122000 24 7I: 0 7 260 2 50 2611' 5533 16- 24-1220 Date aDollar w 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 BACKFI LL 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 I 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: Z- -- JOB DESCRIPTION: ,' ( ,;U OCCUPANCY TYPE: OWNER: PERMIT NO. CONTRACTOR: PHONE # FD 1743