HomeMy WebLinkAbout1415 TRUXTUN AVENUEHOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
R.::. 000 /.3
File Number: C2 Address-. /-ells %;"UXi
UNDERGROUND STORAGE TANKS
FACILITY % /
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APPLICATION
R D
FIRS
OWNER NAME
ARTM r
TO PERFORM ELD /LINE TESTING/
OF TANKS TO BE TESTED:
SB989 SECONDARY CONTAINMENT
TANK #
TESTING /TANK TIGHTNESS TEST AND
CONTENTS
FUEL MONITORING CERTIFICATION
Please note that these are separate
individual tests and will be charged per
separate type test accordingly.)
PERMIT #
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661 - 326 -3979 • Fax: 661 - 852 -2171
Page 1 of 1
ENHANCED LEAK DETECTION LINE TESTING SB -989 SECONDARY CONTAINMENT
TANK TIGHTNESS FUEL MONITORING CERTIFICATION
SITE INFORMATION
FACILITY % / NAME & PHONE # OF CONTACT PERSON
ADDRESS
OWNER NAME
OPERATOR NAME
I")* G
PERMIT TO OPERATE #
OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? YES NO
TANK # VOLUME CONTENTS
TANK TESTING COMPANY
TESTING COMPANY NAME & PHONE # OF CONTACT PERSON qq
1
MAILING ADDRESS
o x yf /
n &AC/JI
ESTERNA3E & PHONE # OF OR SPECIAL INSPECT 6R
ti S lM
ERTIFICATION #
DATE & TIME TEST TO BE CONDUCTED ICC # TEST METHOD
APPLICANT SIGN DATE
7 —/ —z—
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
APPROVED B —Y ^/ DATE !,
FD2095 (Rev 03/08)
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)
REMARKS:
BUILDING ADDRESS: / " veLj
JOB DESCRIPTION: vtil C, OCCUPANCY TYPE: Z
OWNER: - ` Aj PERMIT NO. /o2- /OO4Cll3
CONTRACTOR: f<e ,-Pu a - w o '. PHONE #
FD 1743