HomeMy WebLinkAbout4013 H STREET SB-989 2013HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
File Number: 36 z- Z Address: -9,d 3 5 • -,q 5'-
Bakersfield, CA 933
Date Received:
Business Name: " =S-;
SYSTEM: BUILDING SQUARE FEET: INSPECTION LOG
New Mod.
Commercial Hood System
Fire Alarm System
Fire Sprinkler System
Spvay FWsh System
Aboveground Storage Tank
Underground Storage Tank
minor
modification Underground Storage Tank
removal Underground Storage Tank
Building Sq. Feet:
Calculation Bldg. Sq. Ft:
W
0,- Other. S 3 g X 2
Comments:
3.
4.
Date Time
Signature
A304,
C'rl
L IL-
Signature
A304,
C'rl
SWRCB, January 2002 Page of
Secondary Containment Testing Report Form
Thisform is intendedfor use by contractors performing periodic testing ofUSTsecondary containment systems. Use the
appropriate pages ofthisform to report results for all components tested. The completedform, written test procedures, and
printoutsfrom tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: #7721 Fastrip # 22 (North) Date ofTesting: May 7 -8, 2013
Facility Address: 4013 South -H- Street Bakersfield, CA 93304
Facility Contact: Omero Garcia I Phone: 661 - 393 -7000
Date Local Agency Was Notified of Testing: 5/1/2013
Name of Local Agency Inspector (fpresent during testing): Esther Duran
SWRCB Licensed Tank Tester
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services
Pass Fail
Technician Conducting Test:
Repairs
Made
Component
Credentials: x CSLB Licensed Contractor SWRCB Licensed Tank Tester
Not
Tested
License Type: CSLB
87 Annular
License Number:804904
Manufacturer
Manufacturer Training
Component(s) Date Training Expires
UST
Installaton/Retrofit
11/22/2013
UST Service
technician
ICC 1 -28 -2015
Star. Smith. Fibercast Fiber Glass Systems N.A.
UDC 17 -18 X
3. SUMMARY OF TEST RESULTS
Component Pass Fail Not
Tested
Repairs
Made
Component Pass Fail Not
Tested
Repairs
Made
87 Annular X UDC 15 -16 X X
91 Annular X UDC 17 -18 X
Diesel Annular X UDC 19 -20 X
87 Secondary Line X 87 Vapor Spill Bucket X
91 Secondary Line X 91 Vapor Spill Bucket X
Diesel Annular Line X X 0
87 STP Sump X X
91 STP Sump X 0 0 0 0
Diesel STP Sump X
UDC 9 -10 X 0
UDC 11 -12 X 1 X 0 0 0 0
UDC 13 -14 X 0 0 0 0
If hydrostatic testing was performed, describe what was done with the water after completion of tests:
Water was put back into test trailer and waste drum
CERTIFICATION OF TECHNICIA VESP NSIBLE FOR CONDUCTING THIS TESTING
To the best ofmy knowledge, facts stated i this are accurate and infull compliance with legal requirements
Technician's Signature: Date: 05/07- 08/2013
SWRCB, January 2002 Page of
4. TANK ANNULAR TESTING
Test Method Developed By: Tank Manufacturer x Industry Standard Professional Engineer
Other (Spec)
Test Method Used: Pressure x Vacuum Hydrostatic
Other (Specie)
Test Equipment Used: Calibrated Gages Equipment Resolution:0.0625"
Tank # 87 Tank # 91 Tank # Diesel Tank #
Is Tank Exempt From Testing ?' Yes X No Yes X No Yes X No Yes No
Tank Capacity: 12,000 12,000 12,000
Tank Material: STEEL/ FRP STEEL/ FRP STEEL /FRP
Tank Manufacturer: Modern Welding Modern Welding Modern Welding
Product Stored: 87 Annular 91 Annular Diesel Annular
Wait time between applying
pressure /vacuum /water and
starting test:
5 Mins 5 Mins 5 Mins
Test Start Time: 9:45 am 9:45 am 9:45 am
Initial Reading (Rj): 10.00" Hg 10.00" Hg 10.00" Hg
Test End Time: 10:45 am 10:45 am 10:45 am
Final Reading (RF): 10.00" Hg 10.00" Hg 10.00" Hg
Test Duration: 1 Hour 1 Hour 1 Hour
Change in Reading (RF -Ri): 0.00" 0.00" 0.00"
Pass/Fail Threshold or Criteria: 0.00" 0.00" 0.00"
Test Result: X Pass 0 Fail X Pass Fail X Pass "' Fail'- Pas's ' Fail'"
Was sensor removed for testing? X Yes No NA X Yes No NA X Yes No NA Yes No NA
Was sensor properly replaced and
verified functional after testin ? X Yes No NA X Yes No NA X Yes No NA Yes No NA
Comments — (include information on repairs made prior to testing, and recommendedfollow -up forfailed tests)
Single Wall Tanks
Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary
containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment
testing. {California Code of Regulations, Title 23, Section 2637(a)(6))
T
SWRCB, January 2002
5. SECONDARY PIPE TESTING
Page of
Test Method Developed By: Piping Manufacturer x Industry Standard Professional Engineer
Other (Spec)
Test Method Used: x Pressure Vacuum Hydrostatic
Other (Specie)
Test Equipment Used: Calibrated Gages Equipment Resolution:0.0625"
Piping Run # 87 Piping Run # 91 Piping Run #Diesel Piping Run #
Piping Material: FRP FRP FRP
Piping Manufacturer: Smith Smith Smith
Piping Diameter: 3.00" 3.00" 3.00"
Length of Piping Run: 120' 120' 120'
Product Stored: 87 Secondary 91 Secondary Diesel Secondary
Method and location of
piping-run isolation: Test Boot Test Boot Test Boot
Wait time between applying
pressure /vacuum/water and
starting test:
5 Min 5 Min 5 Min
Test Start Time: 10:30 am 10:30 am 10:30 am
Initial Reading (Rj): 5.00 "PSI 5.00 "PS1 5.00 "PSI
Test End Time: 11:30 am 11:30 am 11:30 am
Final Reading (RF): 5.00 "PSI 5.00 "PSI 5.00 "PSI
Test Duration: 1 Hour 1 Hour l Hour
Change in Reading (RF -R,): 0.00" 0.00" 0.00"
Pass/Fail Threshold or
Criteria: 0.00" 0.00" 0.00"
Test Result: X Pass. Fail X .Pass O'Fail r X, Pass ' " 0 F il P.,Pass Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -up forfailed tests)
I I
SWRCB, January 2002 Page of
6. PIPING SUMP TESTING
Test Method Developed By: Sump Manufacturer x Industry Standard Professional Engineer
Other (Specie)
Test Method Used: Pressure Vacuum x Hydrostatic
Other (Spec)
Test Equipment Used: Ts -sts Equipment Resolution:
Sump # 87 Sump # 91 Sump # Diesel Sump #
Sump Diameter: 37.00" 37.00" 37.00"
Sump Depth: 47.00" 47.00" 47.00"
Sump Material: FRP FRP FRP
Height from Tank Top to Top of
Highest Piping Penetration: 10.00" 14.00" 13.00"
Height from Tank Top to Lowest
Electrical Penetration: 10.00" 15.00" 15.00"
Condition of sump prior to testing: Clean & Dry Clean & Dry Clean & Dry
Portion of Sump Tested' High Penetration High Penetration High Penetration
Does turbine shut down when
sump sensor detects liquid (both
product and water)?*
Yes No X NA Yes No X NA Yes No X NA Yes No NA
Turbine shutdown response time N/A N/A N/A
Is system programmed for fail -safe
shutdown ?*
Yes No X NA Yes No X NA Yes No X NA Yes No NA
Was fail -safe verified to be
operational?* Yes No X NA Yes No X NA Yes No X NA Yes No NA
Wait time between applying
pressure /vacuum/water and starting
test:
5 Min 5 Min 5 Min
Test Start Time:
Initial Reading (Rj):
Test End Time: See INCON
Final Reading (RF): Resuh
Test Duration:
Change in Reading (RF -Ri):
Pass /Fail Threshold or Criteria:
Test Result: X Pass . Fail : X Pass.' ` 0 Fail X Pass. ,Fail. D Pass_ 0 Fair ;, :
Was sensor removed for testing? X Yes No NA X Yes No NA X Yes No NA Yes No NA
Was sensor properly replaced and
verified functional after testing? X Yes No NA X Yes No NA X Yes No NA Yes No NA
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
Ifthe entire depth of the sump is not tested, specify how much was tested. If the answer to qny of the questions indicated with an
asterisk(*) is "NO" or "NA ", the entire sump must be tested. (See SWRCB LG -l60)
t \'A
SWRCB, January 2002
7. UNDER- DISPENSER CONTAINMENT (UDC) TESTING
Page of
Test Method Developed By: UDC Manufacturer x Industry Standard Professional Engineer
Other (Spec)
Test Method Used: Pressure Vacuum x Hydrostatic
Other (Spec)
Test Equipment Used: Ts -sts Equipment Resolution:
UDC # 9 -10 UDC # 11 -12 UDC # 13 -14 UDC # 15 -16
UDC Manufacturer: Gilbarco Gilbarco Gilbarco Gilbarco
UDC Material: Polly Polly Polly Poll
UDC Depth: 29.00" 29.00" 29.00" 29.00"
Height from UDC Bottom to Top
of Highest Piping Penetration:
12.00" 10.00" 10.00" 10.75"
Height from UDC Bottom to
Lowest Electrical Penetration:
4.00" 4.00" 4.00" 4.00"
Condition of UDC prior to
testing:
Clean & Dry Clean & Dry Clean & Dry Clean & Dry
Portion ofUDC Tested High Penetration High Penetration Hi h Penetration High Penetration
Does turbine shut down when
UDC sensor detects liquid (both
product and waterp.
Yes No X NA Yes No X NA Yes No X NA Yes No X NA
Turbine shutdown response time N/A N/A N/A N/A
Is system programmed for fail-
safe shutdown ?' Yes No X NA Yes No X NA Yes No X NA Yes No X NA
Was fail -safe verified to be
o erational ?`
Yes No X NA Yes No X NA Yes No X NA Yes No X NA
Wait time between applying
pressure /vacuum /water and
starting test
5 Min 5 Min 5 Min 5 Min
Test Start Time:
Initial Reading (Ri): See-
Test End Time: Egg] Final Reading (RF): Res
Test Duration:
Change in Reading (RF -Ri):
Pass/Fail Threshold or Criteria:
Test Result: X Pass . Fail' ; X .Pass Fair- - X Pass. - Fair X lass t..FAAI;, -:
Was sensor removed for testing? JXYes No NA X Yes No NA X Yes No NA X Yes No NA
Was sensor properly replaced and
verified functional after testing? X Yes No NA X Yes No NA X Yes No NA X Yes No NA
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
Ifthe entire depth ofthe UDC is not tested, specify how much was tested. If the answer to as of the questions indicated with an
asterisk(*) is "NO" or "NA ", the entire UDC must be tested. (See SWRCB LG -160)
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SWRCB, January 2002 Page of
7. UNDER- DISPENSER CONTAINMENT (UDC) TESTING
Test Method Developed By: UDC Manufacturer x Industry Standard Professional Engineer
Other (Spec)
Test Method Used: Pressure Vacuum x Hydrostatic
Other (Spec)
Test Equipment Used: Ts -sts Equipment Resolution:
UDC # 17 -18 UDC # 19 =20 UDC # UDC #
UDC Manufacturer: Gilbarco Gilbarco
UDC Material: Polly Poll
UDC Depth: 29.00" 29.00"
Height from UDC Bottom to Top
of Highest Piping Penetration:
12.00" 12.00"
Height from UDC Bottom to
Lowest Electrical Penetration:
6.00" 6.00"
Condition of UDC prior to
testing:
Clean & Dry Clean & Dry
Portion of UDC Tested High Penetration High Penetration
Does turbine shut down when
UDC sensor detects liquid (both
product and water) ?`
Yes No X NA Yes No X NA Yes No NA Yes No NA
Turbine shutdown response time N/A N/A
Is system programmed for fail-
safe shutdown ?* Yes No X NA Yes No X NA Yes No NA Yes No NA
Was fail -safe verified to be
operational?*
Yes No X NA Yes No X NA Yes No NA Yes No NA
Wait time between applying
pressure /vacuum /water and
starting test
5 Min 5 Min
Test Start Time:
Initial Reading (RI):
Test End Time:
Final Reading (RF): Results
Test Duration:
Change in Reading (RF -Ri):
Pass/Fail Threshold or Criteria:
Test,Result:- - - X Pass_. Fail X .Pass Fail 1- -.. Pass Fail
h -
Pass f7 Fail
Was sensor removed for testing? X Yes No NA X Yes No NA Yes No NA Yes No NA
Was sensor properly replaced and
verified functional after testin ? X Yes No NA X Yes No NA Yes No NA Yes No NA
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
1 If the entire depth of the UDC is not tested, specify how much was tested. Ifthe answer to any of the questions indicated with an
asterisk ( *) is "NO" or "NA ", the entire UDC must be tested. (See SWRCB LG -160)
I I
SWRCB, January 2002
8. FILL RISER CONTAINMENT SUMP TESTING
Page of
Facility is Not Equipped With Fill Riser Containment Sumps
Fill Riser Containment Sumps are Present, but were Not Tested X
Test Method Developed By: Sump Manufacturer Industry Standard Professional Engineer
Other (Spec)
Test Method Used: Pressure Vacuum Hydrostatic
Other (Spec)
Test Equipment Used: Equipment Resolution:
Fill Sump # Fill Sump # Fill Sump # Fill Sump #
Sump Diameter:
Sump Depth:
Height from Tank Top to Top of
Highest Piping Penetration:
Height from Tank Top to Lowest
Electrical Penetration:
Condition of sump prior to
testing:
Portion of Sump Tested
Sump Material:
Wait time between applying
pressure /vacuum/water and
starting test:
Test Start Time:
Initial Reading (R,):
Test End Time:
Final Readin (RF):
Test Duration:
Change in Reading (RF -R,):
Pass/Fail Threshold or Criteria:
Test Result: Pass.. D Fail . Pass. Fail_ Pass,,,_.D,Fail 0 Pass.._ D Fail,,
Is there a sensor in the sump? Yes No Yes No Yes No Yes No
Does the sensor alarm when
either product or water is
detected?
Yes No NA Yes No NA Yes No NA Yes No NA
Was sensor removed for testing? Yes No NA Yes No NA j Yes No NA Yes No NA
Was sensor properly replaced and
verified functional after testing? yes No NA Yes No NA Yes No NA Yes No NA
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
SWRCB, January 2002 Page of
9. SPILL/OVERFILL CONTAINMENT BOXES
Facility is Not Equipped With Spill/Overfill Containment Boxes
Spill/Overfill Containment Boxes are Present, but were Not Tested
Test Method Developed By: Spill Bucket Manufacturer x Industry Standard Professional Engineer
Other (Spec)
Test Method Used: Pressure Vacuum x Hydrostatic
Other (Specie)
Test Equipment Used: Ts -sts Equipment Resolution:
Spill Box # 87 Vapor Spill Box # 91 Vapor Spill Box # Spill Box #
Bucket Diameter: 12.00" 12.00"
Bucket Depth: 12.00" 12.00"
Wait time between applying
pressure /vacuum /water and
starting test:
5 Mins 5 Mins
Test Start Time: 9:45 am 9:45 am
Initial Reading (Rj): 10.25" 11.00"
Test End Time: 10:45 am 10:45 am
Final Reading (RF): 10.25" 11.00"
Test Duration: 1 Hour 1 Hour
Change in Reading (RF -Rj): 0.00" 0.00"
Pass/Fail Threshold or
Criteria: 0.00" 0.00"
Test Result: X Pass Fail : X, Pass , Fail r Pass Fail : 0 Pass . Fail--
Comments — (include information on repairs made prior to testing, and recommendedfollow -up forfailed tests)
4O F GEN
t.UST= y Job Order / Invoice # 3 U-7 U
BUILD WITH CONFIDENCE"
Date Call Made Time To Whom Station Control Number Repajr Daze Invoice DateTollFree #: 1- 800 - 339 -9930 `
Y /GV/
Name Confidence UST Construction Inc. Site Name:
s Street 16250 Meacham Road o Street / JUW
City Bakersfield,Ca 93314 City Stat Zip01U
Terms Store Number: 7
Description of work performed: r S
vt
r
Yl G
Labor
Date Name /Number Class Hours Hourly Amount
Arrived Departed Labor Travel Total Rate }
t PM O P
AM AM
PM PM
AM AM
PMI PM
mPlayee S gna ! ire Dale Ver;dor S gna[uro Dtcie
Contractor Supplied - Materials - Rentals Amount Sub -Total
Quantity
Total A Labor
Total B Material
Total C Mileage
Total Amount
Invoice A + B + C
Accounting Breakdown
Mileage
Miles Rate Total Sub Total
Handling %
Tax ( If applicable)
Total C I Total B
May we please have your comments regarding service / equipment provided by the above named contractor:
Store Employee Printed Name '
elure Date Approved By Date
INVOfCE - WHITE Y SITE-CANARY
1
I
7721 FASTRIP
7721 FASTRIP
4013 SOUTH H 7721 FASTRIP
BAKERSFIELD CA 4013 SOUTH H
661- 393 -7000 BAKERSFIELD CA
WO -30708 661- 393 -7000
NO -30708
WO -30708
05/08/2013 8:16 AM
C 5/09/2013 9:21 AM
05/08/2013 8:32 AM
05/09/2013 8:48 AM
SUMP LEAK TEST REPORT
SUMP LEAK TEST REPORT
SUMP LEAK TEST REPORT
SUMP LEAK TEST REPORT
19 -20
87 -STP
19-20
87 -STP
TEST STARTED 8 :01 AM
TEST STARTED 9:05 AM
TEST STARTED 05/08/2013 TEST STARTED 8:33.AM
BEGIN LEVEL 3.3526 IN TEST STARTED 05/09/2013
END TIME 8:16 AM BEGIN LEVEL 3,2130 IN
END DATE 05/08/2013 END TIME 8:48 AM
END LEVEL 3,3519 IN END DATE 05/09/2013
EAK THRESHOLD 0,002 IN END LEVEL 3,2116 IN
IEST RESULT PASSED LEAK THRESHOLD 0,002 IN
TEST RESULT . PASSED
TEST RESULT PASSED
7721 FASTRIP
4013 SOUTH H
BAKERSFIELD CA
661 - 393 -7000
NO -30708
05/07/2013 10:50 AM
SUMP LEAK TEST REPORT
DIE -STP
TEST STARTED 10:35 AM
TEST STARTED 05/07/2013
BEGIN LEVEL 3,7319 IN
END TIME 10:50 AM
END DATE 05/07/2013ENDLEVEL3.7329 IN
LEAK THRESHOLD 0,002 IN
TEST RESULT PASSED
ST(
TEF , 1.M
TE 'ED ,'/2013
BEGiti . °, - 72 IN
END TIME ?`:50 AM
END DAIC 0:,Ur12013
END LEVEL 2, 9678 If,
LEAK THRESHOLD 0,002 IN
TEST RESULT PASSED
7721 FASTRIP
7721 FASTRIP 4013 SOUTH H
4013 SOUTH H BAKERSFIELD CA
BAKERSFIELD CA 661- 393 -7000
661- 393 -7000 WO -30708
NO -30708
C 5/09/2013 9:21 AM
05/08/2013 8:32 AM
SUMP LEAK TEST REPORT
SUMP LEAK TEST REPORT
87 -STP
19-20
TEST STARTED 9:05 AM
TEST STARTED 8:17 AM TEST STARTED 05/09/2013
TEST STARTED 05/08/2013 BEGIN LEVEL 3,2085 IN
BEGIN LEVEL 3,3516 IN END TIME 9:20 AM
END TIME 8:32 AM END DATE 05/09/2013
END DATE 05/08/2013 END LEVEL 3.2069 IN
END LEVEL 3,3517 IN LEAK THRESHOLD 0,002 IN
LEAK THRESHOLD 0,002 IN TEST RESULT PASSED
TEST RESULT . PASSED
7721 FASTRIP
4013 SOUTH H
BAKERSFIELD CA
661 - 393 -7000
NO -30708
05/07/2013 10:50 AM
SUMP LEAK TEST REPORT
DIE -STP
TEST STARTED 10:35 AM
TEST STARTED 05/07/2013
BEGIN LEVEL 3,7319 IN
END TIME 10:50 AM
END DATE 05/07/2013ENDLEVEL3.7329 IN
LEAK THRESHOLD 0,002 IN
TEST RESULT PASSED
ST(
TEF , 1.M
TE 'ED ,'/2013
BEGiti . °, - 72 IN
END TIME ?`:50 AM
END DAIC 0:,Ur12013
END LEVEL 2, 9678 If,
LEAK THRESHOLD 0,002 IN
TEST RESULT PASSED
7721 FASTRIP
4013 SOUTH H
BAKERSFIELD CA
661 - 393 -7000
WO-30708
05/07/2013 11 :06 AM
SUMP LEAK TEST REPORT
DIE —STP
TEST STARTED 10:51 AM
TEST STARTED 05 /07/2013
BEGIN LEVEL 3,7329 IN
END TIME 11:06 AM
END DATE 05/07/2013
END LEVEL 3,7334 IN
LEAK THRESHOLD 0,002 IN
TEST RESULT PASSED
91 -STP
TEST STARTED 10:51 AM
TEST STARTED 05 /07/2013
BEGIN LEVEL 2,9680 IN
END TIME 11:06 AM
END DATE 05 /07/2013
END LEVEL 2,9682 IN
LEAK THRESH' o., JA
TEST RESULT 'ASSED
FASTRIP
7721
BACKERSFIELD
1 -800- 984 -6266
05/10/2013 12:41 PM
SUMP LEAK TEST REPORT
UBC1516
TEST STARTED 12:25 PM
TEST STARTED 05/10/2013
BEGIN LEVEL 5,5195 IN
END TIME 12:41 PM
END DATE 05/10/2013
END LEVEL 5.5195 IN
LEAK THRESHOLD 0,002 IN
TEST RESULT PASSED
FASTRIP
7721
BACKERSFIELD
1- 800 -984 -6266
05/10/2013 12:56 PM
SUMP LEAK TEST REPORT
UDC1516
TEST STARTED 12:41 PM
TEST STARTED 05/10/2013
BEGIN LEVEL 5,5195 IN
END TIME 12:56 PM
END DATE 05/10/2013
END LEVEL 5.5193 IN
LEAK THRESHOLD 0,002 -IN
TEST RESULT PASSED
772?. hr,
4011
BACKE
66i -3' -r'L
5/07/101' -
UDC1718
EST STARTED PM
TEST 0' `13
BEGIN LEVEL 217 IN
END TIME l3 ?I
dD DATE 05, r,/
NP LEVEL v
AK THRESHOLD 0.-
TEST RESULT (E0
721 iIP
41? ~
3A XF.
3/07/201'
LIMP LEAK TEE.-T
UX171S,
EST STARTED 1:14 PP7.ST STARTED 05/07/ 3LEVEL5.4217
TIME 1. ?,,RmATE05/07, r'..:•
ND LEVEL 5 { , EA9 THRESHOLD 0. 2• inSTRESULTpASED
7721 FASTRIP
7721 FASTRIP 4013 SOUTH H
4013 SOUTH H BAKERSFIELD CA
BAKERSFIELD CA 661- 393 -7000
661- 393 -7000 WO-30708
WO -30708
05/07/2013 2:03 PM
05%07/2013 1:47 PM
SUMP LEAK TEST REPORT
SUMP LEAK TEST REPORT
9 -10
9-10
TEST STARTED 1:48 PM
TEST STARTED 1:32 PM TEST STARTED 05/07/2013
TEST STARTED 05/07/2013 BEGIN LEVEL 6,3825 IN
BEGIN LEVEL 6.3827 IN END TIME 2:03 PM
END TIME 1:47 PM END DATE 05 /07/2013
END DATE 05/07/2013 END LEVEL 6,3823 IN
END LEVEL 6,3825 IN
LEAK
THRESHOLD 0,002 IN
LEAK THRESHOLD 0,002 IN TEST RESULT PASSED
TEST RESULT PASSED
11 -12
11 -12
TEST STARTED 1:48 PM
TEST STARTED 1:32 PM TEST STARTED 05/07/2013
TEST STARTED 05 /07/2013 BEGIN LEVEL 2,0291 IN
BEGIN LEVEL 2.0300 IN END TIME 2:03 PM
END TINE 1 :47 PM END DATE 05/07/2013
END DATE 05/07/2013 END LEVEL 2,0289 IN
END LEVEL 2.0290 IN LEAK THRESHOLD 0,002 IN
LEAK THRESHOLD 0,002 IN TEST RESULT PASSED
TEST RESULT PASSED
13 -14
13 -14
TEST STARTED 1:48 PM
TEST STARTED 1:32 PM TEST STARTED 05 /07/2013
TEST STARTED 05/07/2013 BEGIN LEVEL 5,9272 IN
BEGIN LEVEL 5,9276 IN END TIME 2:03 PMENDTIME1:47 PM END DATE 05/07/2013ENDDATE05/07/2013 END LEVEL 5.9270 IN
END LEVEL 5,9274 IN LEAK THRESHOLD 0,002 IN
LEAK THRESHOLD 0,002 IN TEST RESULT PASSED
TEST RESULT PASSED
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)
BUILDING ADDRESS: (3 5 • f-i is-(,
JOB DESCRIPTION: 3 - OCCUPANCY TYPE:
OWNER: -
tom
siT i PERMIT NO. 13 -/ Ql
CONTRACTOR: Cow Yvc PHONE # /-- 39'j6
FD 1743
0
BILLING ~ PERMIT STATEMENT
nNi" ag -1 1- D
PERMIT # FIREdj!ARTM T
ilnulpl.
LOCATION OP PROJECT
STARTING DATE COMPLETION DATE
11RO)VCT NAME:
PROJECT AD RUSS
Iih1?. G..,1k- oIk11
ADDRESS
P(AME
1 --U L
OWNER
BAiKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
hone_ 6611-32 -3979 • Fax: 6F1 -RS? -?171
1I .....,.- _..Si.G. lR IICLZf1C? _._ rU!GU eY
ADDRESS
1u..
PHONE M —.... _..—.
82515
CITY BA`-Er,,,,Sr- IEL-D STATE CA ZIP cODF
c-133Z - 2515
CA LICENSE # i TYPE OF LICENSF.
313 i
CITY
Please make checks payabile to CITY OF BAKERSFIELD. Thank you.
PHONE 9
FAX #
Cl.a1.o_ 5?5 =1 —`'ice
ZIP CODE
CI x'A t
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DOLLARS
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MEMO
Permit
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Underground Storage Tank (Minor Modification) M I m X10/ /Sloe .._
1 Underground Storage Tank (Removal) TR 573 /tank 84
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p. 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
0 Oil well (Installation, Inspection, or re- inspection) X 96 /hr 82
Tent # 96 /tent 84
I 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 /insp) = $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
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UNDERGROUND STORAGE TAMRS
APPLICATION
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S119',39 SECONDAPY r-OKI-I'AINMENT
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BAKERSHELID FIRE DEPART14EAGy
WOO *1'1'1.1)-'I.'Ll)) Ave., Sj.fij:(,
0 #YPAN AjVjjVr CA 9330).
Phone: r)c)], J).-,) 6-3979 c
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TANVITSTING COMPANY
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THIS APPLICATION BECOMES A PERWIXY WHEN APPROVED
DAYI:
1:112.11,15 (1?,!v 4(;J(Iej
nwILi1NG-& FERNY STATEMENT ,l lili p;q;;•
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PERMIT
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BAKERSFIELD FIRE DEPARTMENT
Prevention: Services
2101 H Street
Bakersfield, CA 93301
Phnna.,f,F,:1.- - Q7Q..Fav• 1_ar_
O5 Y1 -4 5V
r,.,. , .. .. - _,.r T,.,- .- .,._•Y --,.. _.._._r,- .. P RTY OWNER
Qin 1
STARTI DATE CID ON DATE
q AM
NAME
Gard' \
MI
PROJECT NAME ADDRESS PHONE #
1,2 U 1 - - IkLOPROJECTApbREss
11 CITY $ ERS 16L_D STATE CA z
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CONTRACTOR, INFORIM AT'ON
CO CTOR'N{N1E CA LICE SE #
X10
TYPE OF LICENSE EXPIRATION ATE ` ?PHONE'#
0 3181 %l 1
o .._ ..- ......: _.._ _ . .
3 -
CONTRACTOR COMPANY NAME FAX #
15"1 -158
ADDRESS CITY 2IP CODE
3
Please make checks oavable to CM OF BAKERSFIELD. Thank you.
EI PERMIT TYPE FEE CALCULATION TOTAL
DUE
Alarm New & Modification (minimum charge) $280
TRE'S
ccT
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
O 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
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/hrduring 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
FD2021_lRev.05/111___.