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Home My WebLink About430 CALIFORNIA AVENUE UST 2013o u HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. 1-? lG!60 36 File Number: Q ' Address: r' 4 3 Off, OAS 7"1-) - Bakersfield, CA 933 Date Received: c `z — 13 _ Business Name: SYSTEM: BUILDING SQUARE FEET: INSPECTION LOG New Mod. Commercial Hood System Fire Alarm System Fire Sprinkler System spFay Finish System f / Aboveground Storage Tank Underground Storage Tank minor modification Underground Storage Tank V I nderground Storage Tank Other. Comments: Building Sq. Feet: Calculation Bldg. Sq. Ft: 2. 3. 4. Date Time Signature Signature WAY so PLJrEPi¢sssul6 -t r Esvr 4LN- s JAW P,e6ss cntBT 7AW11 1 91 s- SFC. Tzr- Signature Signature WAY so P ztouu- r I "tin 1 SWRCB, January 2002 Page of J Secondary Containment Testing Report Form Thisform is intendedfor use by contractors performing periodic testing ofUST secondary containment systems. Use the appropriate pages ofthis form to report resultsfor all components tested. The completedform, written test procedures, and 1printoutsfrom tests applicable), should beprovided to thefacility owner /operator for submittal to the local regulatory agency. nn 6 1. - FAGILITY P,,P ORNLVrION I 2. TESTING CONTRACTOR INFORMATION Company Name: Franzen -Hill mm WR Technician Conducting Test: t) r'i'iG r^i tti iFi"+" i1:l G3n1Ll lt' 95WRCB.Licensed Tank Tester License Type: B C611D40 A HAZ License Number: 304147 Manufacturer Manufacturer Training Component(s) Datelraining Expires 2. TESTING CONTRACTOR INFORMATION Company Name: Franzen -Hill mm WR Technician Conducting Test: t) Credentials: E CSLB Licensed Contractor 95WRCB.Licensed Tank Tester License Type: B C611D40 A HAZ License Number: 304147 Manufacturer Manufacturer Training Component(s) Datelraining Expires 3. SUMMARY OF TEST RESULTS I - mm WR I DO 0 000 mom 00mm 00 DOB DO O MM tom a000 noo. 0000 0000 onoo 0000 000 or.o Ifhydrostatic testing was performed, describe what was done with the water after completion oftests: CERTIFICATION OF TECHNICIAN RESPO IBLE FOR CONDUCTING THIS TESTING To the best ofmy knowledge, diefacts stated in thls documen are accurate and Infull compliance with legal requirements Technician's Signature: J Date:Q i i I SWRCB, January 2002 I Page Off —7 5. SECONDARY PIPE TESTING Test Method Developed By: Piping Manufacturer dustry Standard Professional Engineer Other (Specify) Test Method Used: Pressure Vacuum Hydrostatic Other (S eci ) Test Equipment Used: P, h Equipment Resolution: Pi Run , aping Run # Piping Run # Piping Run # Piping Material: Piping Manufacturer. 3 Piping Diameter: t Length ofPiping Run: Product Stored: WS Qj Method and location of evpiping-run isolation: O Wait time between applying pressure /vacuum/water and starting test: Aylt Test Start Time: Initial Reading (111): Test End Time: 3 O Final Reading (RF): Test Duration: Change in Reading (RF -Rj): Pass/Fail Threshold or Criteria: Sf Test Result: CRZass Fail Pass Fail Pass Fall Pass Fail L , SWRCB, January 2002 ^ r Page I of 2— Secondary Containment Testing Report Form E Thisform is intendedfor use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages ofthisform to report resultsfor all components tested. The completedform, written test procedures, and printouts from tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION 1 2. TESTING CONTRACTOR INFORMATION Company Name: Franzen -Hill Technician Conducting Test: M.4 ck),11-Au's d1q A9 go Credentials: - CSLB Licensed Contractor SWRCB Licensed Tank Tester License Type: B C61/1340 A HAZ License Number: 304147 Manufacturer Training Manufacturer Component(s) Date Training Expires 3. SIJMMARV OF TEST RF,STJLTS i 1 1 I I 1 I:• 1 I 1 1 1. • 1 If hydrostatic testing was performed, describe what was done with the water after completion of tests: CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best ofmy knowledge, thefacts stated In this document are accurate and infull compliance with legal requirements Technician's Signature: ,, Date: r SWRC9, January 2002 6. PIPING SUMP TESTING Page 2 of 2 Test Method Developed By: Sump Manufacturer Y,,Industry Standard Professional Engineer Other (Spec) Test Method Used: Pressure Vacuum ydrostatic Other (Spec) Test Equipment Used: Equipment Resolution: , t Sump Diameter: Sump # Sump # Sump # Sump # 0 Sump Depth: Sump Material: 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 ofSump Tested` Does turbine shut down when sump sensor detects liquid (both product and water)?* Yes No NA ALWYes No NA Yes No NA Yes No NA Turbine shutdown response time Is system programmed for fail -safe shutdown? Yes No NA Yes No ANA Yes No NA Yes No NA Was fail -safe verified to be operational?* Yes No NA Yes No h(NA Yes No NA Yes No NA Wait time between applying pressure /vacuum/water and starting test: J 5nn, N• Test Start Time: Initial Reading (Ri): Test End Time: Final Reading (RF): Test Duration: 15 , AA Change in Reading (RF -R1): Pass/Fail Threshold or Criteria: r OOA Test Result: Pass Fail Pass Fail Pass Fail Pass Fall Was sensor removed for testing? Yes No NA KYYes No NA Yes No NA Yes No NA Was sensor properly replaced and verified functional after testing? Yes No NA Yes No NA D Yes b No NA Yes No NA Comments — (include Information on repairs madeprior to testing, and recommendedfollow -upforfailedtests) Ifthe entire depth ofthe sump 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 sump must be tested. (See SWRCB LG -160) f RANBIR GASCO 430 E CALIFORNIA BAKERSFIELD CA 93305 661343 -0563 1 4 -6266 2013 11:36 AM SUMP LEAK TEST REPORT 87 STP TEST STARTED 11:21 AM TEST.SIARTEO 07/22/2013 BEGIN LEVEL 6,2347 IN END TIME 11:36 AM END DATE 07/22/2013 END LEVEL 6,2364 IN LEAK THRESHOLD 0,002 IN TEST RESULT PASSED r . y r i +.11 ?-ra, l ... v i:... y BILLING & PERMIT STATEMENT PERMIT # Pine wAv ri r 1{iyIlNu. BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phnna- AiA,1- '47A, - ;Q7Q a Far• Ff t - RS7_71 71 SITE INFORMATION LOCATION OF PROJECT / PROPERTY OWNER STARTING DATE COMPLETION DATE NAME _ PROJECT NAME ADDRESS PHON 1 PROJECT ADDRESS CITY gAK ERSR EL-1) STATE CA ZIP CODE US CONTRACTOR INFORMATION CONTRACTOR NAME CA LICENSE d li C,LXI 1 CC3 v—f TYPE OF LICENSE EXPIRATION ATE 1 S PHONE i 29 -7 7 CONTRACTOR COMPA AME FAX d ADDRESS O CITY 0—rc, ZIP COD, Please make checks payable to CITY OF BAKERSFIELD. Thank you. Alarm - New & Modification (minimum charge) $280 NO 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 11 Sprinkler — Minor Modification ( <10 heads) 96 (inspection only) 84 Commercial Hood (New & UL 300 Upgrade Modification) Additional Hood 235 58 hood Commercial Hood - Minor Modification (add /move nozzle) 96 (Inspection only) 84 Spray Booth (New & Modification) 235 98 lAboveground 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) - ••u•NI 878 /tank -- 82-- Underground Storage Tank (Modification) MOD 878 /site — lscorr,o en,V 82 Underground Storage Tank (Minor Modification) MTM 167 /site 82 Underground Storage Tank (Removal) TR 573 /tank 84 O Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot. NOTE: $96 /hr for each type of test/per site /per UST system ven 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 BILLING & PERMIT STATEMENT lelos BAKERSFIELD FIRE DEPARTMENT Prevention Services PERMIT # PIRA 2101 H Street RfMI` r Bakersfield, CA 93301N CONTRACTOR COMPAN LNAME FAX 0 ADDRESS I ` G } 1 C CITY TLO ZIP Dlonre f•YFv f!C DAVC1112CG4CY f% T1.....6..... 19VAU" BUSINESS BANK Franzen-Hill Co oration nee:: e-rqA CenwAil, ` PEI ® 1901 EProeP lUlare CA 83274 1100 Nort1 7 •Straet,Tularo,CA932741939 '""'' k^ q, (559) 68e -2977 • 90- 4239 -1211 Eight Hundred Seventy -Eight and 00 /100 PAY BAKERSFIELD FIRE DEPARTMENT TO THE ORDER 1501 TRUXTON AVENUE OF BAKERSFIELD, CA 93301 56320 56320 DATE AMOUNT 06/19/13 $* * * * * * ** *878.00 Cj_tFRA a EN CO TI ON AUTHORIZED SIGNATURE 11' 05632011'' I:L2L LL, 23971:00SI LOO LP. 411' Underground Storage Tank (Installation /Inspection) NI SITE INFORMATION 82 Underground Storage Tank (Modification) MOD LOCATION OF PROJECT 7,, 82 PROPERTY OWNER 167 /site 82 Underground Storage Tank (Removal) TR 573 /tank 84 STARTING DATE ' 96 /hr (2 hrs minimum) _ $192 COMPLETION DATE 82 NAME ,) Oil well (Installation, Inspection, or re- inspection) X 96 /hr 82 Tent # 96 /tent 84 PROJECT NAME After -hours Inspection fee 121 /hr (2 hrs minimum) _ $242 ADDRESS PHONE 96 /hr + (5 hrs min standby fee /insp) _ $576 5 hrs min standby fee ins = 605 LUC'v 84 Re- inspection /Follow -up Inspection 96 /hr 1 PROJECT ADDRESS i L CG 11- CITY B/'CICI57ZSFIE5LA STATE aA ZIP CODE , CONTRACTOR INFORMATION CONTRACTOR NAME CA LICENSE 0 TYPE OF LICENSE EXPIRATION DATE 1 PHONE t G. C r C i h,l• fI c IL I CONTRACTOR COMPAN LNAME FAX 0 ADDRESS I ` G } 1 C CITY TLO ZIP Dlonre f•YFv f!C DAVC1112CG4CY f% T1.....6..... 19VAU" BUSINESS BANK Franzen-Hill Co oration nee:: e-r qA CenwAil, ` PEI ® 1901 EProeP lUlare CA 83274 1100 Nort1 7 •Straet,Tularo,CA932741939 '""'' k^ q, (559) 68e -2977 • 90- 4239 -1211 Eight Hundred Seventy -Eight and 00 /100 PAY BAKERSFIELD FIRE DEPARTMENT TO THE ORDER 1501 TRUXTON AVENUE OF BAKERSFIELD, CA 93301 56320 56320 DATE AMOUNT 06/19/13 $* * * * * * ** *878.00 Cj_tFRA a EN CO TI ON AUTHORIZED SIGNATURE 11' 05632011'' I:L2L LL, 23971:00SI LOO LP. 411' Underground Storage Tank (Installation /Inspection) NI 878 /tank 82 Underground Storage Tank (Modification) MOD 878 /site — il ,ccw,vc- : ,, .b;_Njg4 - " 7,, 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 Oven 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 M n..-F_Ld.. I n,- in-- -- --N. " ..O 1 11- C0 m0 m r F