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Home My WebLink Aboutflower st mini mart major mod_1-3■ ■ Commercial Hood System ❑ mino modification removal Fire Alarm System Fire Sprinkler System Spray Finish System Aboveground Storage Tanr�i Underground Storage Tank Underground Storage Tank Underground Storage Tank Building Sq. Feet: Calculation Bldg. Sq. Ft: If V'C--e—� 2. 3. 4. Date Tim7 Signature (2-^\ CID ♦181 t5 Signature UNDERGROUND STORAGE TANK .......... PERMIT APPLICATION TO CONSTRUCT-INSTALL NEW TANK (NEW FACILITY)/NEW TANK INSTALL (EXISTING FACILITY)/MOD-MINOR MOD jPermit # 6 9 TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY f-ur-f-V nrkic: NI! v Mz MnnT1=TrA-rTniu ng: 1:ArT1 TTV ❑ NEW TANK INSTALL/EXISTING FACILITY MTKIC11P MnnTI:TrATTON OF FA(71 T-ry STARTING DATE/ 11/05/2015 PROPOSED COMPLETION DATE 11113/15 FACILITY NAME Express Gas aka Flower Street Mini Mart EXISTING FACILITY PERMIT FACILITY ADDRESS 928 Flower Street CITY Bakersfield ZIP CODE 193305 TYPE OF BUSINESS GDF APN # TANK OWNER Flower Street Mini Mart PHONE # (661) 328-0732 ADDRESS 928 Flower Street CITY Bakersfield ZIP CODE 93305 CONTRACTOR 'Confidence UST Services, Inc. CA LICENSE # ICC # ADDRESS 16250 Meacham Road CITY Bakersfield ZIP CODE 93314 PHONE # 661 - 631 -3870- 1 1 BAKERSFIELD CITY BUSINESS LICENSE # 1 3 . 2864 WORKMANS, COMP # 1308371 INSURER. SCIF BRIEFLY DESCRIBE THE WORK TO BE DONE: Investigate possible leaking tank annular following failed secondary containment testing. Repair leak in vapor return line. WATER TO FACILITY PROVIDED BY DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE # OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL? 1[] YES rl NO SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN ON FILE? n YES NO THIS SECTION IS FOR STORAGE TANK IDENTIFICATION TANK # VOLUME UNLEADED REGULAR PREMIUM DIESEL OTHER 12000 gal (Split) x x 2 8000 gal (Split) "x x Tank Testing Company NAME OF TESTING COMPANY Confidence UST Services, Inc. PHONE NUMBER 661-631-3870 MAILING ADDRESS 16250 Meacham Road, Bakersfield, CA 93314 NAME OF TESTER I ICC# 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 Frank Landa ICC# 8180171-Ul/UT THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FOR OFFICIAL USE ONLY DATE APPROVED APPROVED BY Cn-)n0r- fD REME—i BILLING & PERMIT STATEMENT �� `nom BAKERSFIELD FIRE DEPARTMENT Y3 A W F R T F n Prevention Services PERMIT # F�� a 2101 H Street D�, A ll'i`TM § T %f�t3 C� • Bakersfield, CA 93301 Dh�no• ti� _27�_'2�7� � Gav• titii _52x,7_71 7'1 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. ❑ Alarm - New & Modification (minimum charge) $280 ❑ Over 10,000 sq ft $0 .028 x sq ft ❑ Sprinkler - New & Modification (minimum charge) $280 ❑ Over 10,000 sq ft SITE INFORMATION LOCATION OF PROJECT PROPERTY OWNER 928 Flower Street Flower Street Mini Mart STARTING DATE COMPLETION DATE NAME 11/05/2015 11/13/15 Sam PROJECT NAME ADDRESS PHONE # Express Gas aka Flower Street Mini Mart 928 Flower Street (661) 328 -0732 PROJECT ADDRESS crrY ��IC�TZS�f LLD STATE �'� ZIP CODE 928 Flower Street 93305 CONTRACTOR INFORMATION $470 CONTRACTOR NAME CA LICENSE # TYPE OF LICENSE EXPIRATION DATE PHONE # Frank Landa 804904 A, C61 -D40, Haz 03/31/2016 (661) 631 -3870 CONTRACTOR COMPANY NAME FAX # Confidence UST Services, Inc. (661) 587 -9758 ADDRESS CITY ZIP CODE 16250 Meacham Road Bakersfield 93314 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. ❑ Alarm - New & Modification (minimum charge) $280 ❑ Over 10,000 sq ft $0 .028 x sq ft ❑ Sprinkler - New & Modification (minimum charge) $280 ❑ Over 10,000 sq ft $0 .028 x sq ft ❑ Sprinkler - Minor Modification ( <10 heads) $ 96 (inspection only) 84 ❑ Commercial Hood (New & UL 300 Upgrade Modification) Additional Hood $470 58 hood ❑ Commercial Hood - Minor Modification (add /move nozzle) $ 96 (inspection only) 84 ❑ Spray Booth (New & Modification) $470 98 ❑ Aboveground Storage Tank (1 inspection per installation) AST $180 /tank 82 ❑ Additional Tank ATI $ 96 /tank 82 ❑ Aboveground Storage Tank (Removal, Mod,or Inspect'n) ATR $109 /tank 82 ❑ Underground Storage Tank (Installation /Inspection) NI $878 /tank 82 ❑ Underground Storage Tank (Modification) MOD $878 /site 82 0 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 even if scheduled at the same time $ 96 /hr (2 hrs minimum) = $192 82 ❑ 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 BUILDING ADDRESS: JOB DESC- RIPTION: r ! OCCUPANCY TYPE: OWNER: �-- — 5"?2�c `. /�� l-�'12 r`'� 'PERMIT NQ. � t� 0F6 CONTRACTOR: ! t1 ' PHONE_# 6*