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Home My WebLink AboutFMC PAPERWORK 2019PREPARED 1/23/191 8:39:33 PAYMENT DUE CITY OF BAKERSFIELD PROGRAM BP820L --------------------------------------------------------------------------- APPLICATION NUMBER: 19- 10000044 5100 GASOLINE ALLEY DR FEE DESCRIPTION AMOUNT DUE --------------------------------------------------------------------- - - - - -- PLAN CHECK FEES 98.00 MANDATED LEAK DETECT TEST 98.00 TOTAL DUE 196.00 Please present this receipt to the cashier with full payment. BILLING & PERMIT STATEMENT PERMIT # •''�`' B BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Dhnna• 991 -l7F, -1070 ® F:nv- INFORMATION LOCATION OF PROJECT PROPERTY OWNER 5100 Gasoline Alley Drive, Bakersfield, CA Bill Wright Toyota SCOPE OF WORK NAME PROJECT NAME ADDRESS PHONE # Bill Wright Toyota 5100 Gasoline Alley Drive, CA PROJECT ADDRESS 5100 Gasoline Alley Drive, Bakersfield, CA CITY gK ��1 �l-� STATE C�4 ZIP CODE CONTRACTOR INFORMATION CONTRACTOR NAME CA LICENSE # TYPE OF LICENSE EXPIRATION DATE PHONE # 1804904 IHaz, A, C61 -1314 03/31/2020 661- 631 -3870 CONTRACTOR COMPANY NAME FAX # Confidence UST Services Inc. 661- 587 -9758 ADDRESS CITY ZIP CODE 16250 Meacham Road Bakersfield 93314 Please make checks payable to CI OF BAKERSFIELD. NO CASH Please. Thank you. VONLY El PERMIT TYPE FEE CALCULATION TOTAL TREASURY DUE ACCT NO ❑ Alarm - New & Modification (minimum charge) FA $ 288 ❑ Over 10,000 sq ft $ 0 .0288 x sq ft ❑ Alarm - Minor Modification (Add 1 device /Relocation of 2 devices) $ 98 /hr (2 hrs minimum) _ $196 84 ❑ Sprinkler - New & Modification (minimum charge) FIRE $ 288 ❑ Over 10,000 sq ft $ 0 .028 x sq ft ❑ Sprinkler - Minor Modification ( <10 heads) $ 98 /hr (2 hrs minimum) _ $196 84 ❑ Commercial Hood (New & UL 300 Upgrade Modification) FHD $ 241 Additional Hood $ 59 /hood ❑ Commercial Hood - Minor Modification (add /move nozzle) $ 98 /hr (2 hrs minimum) _ $196 84 ❑ Spray Booth (New & Modification) SB $ 241 ❑ Aboveground Storage Tank (1 inspection per installation) AST $ 185 /tank ❑ Each Additional Tank $ 98/Tank ❑ Aboveground Storage Tank (Removal, Mod, or Inspection) ATR $ 112 /tank ❑ Underground Storage Tank (Installation /Inspection) NI $ 900 /tank ❑ Underground Storage Tank (Modification) MOD $ 900 /site ❑ Underground Storage Tank (Minor Modification) MTM $ 171 /site ❑ Underground Storage Tank (Removal) TR $ 587 /tank 0 Mandated UST Testing: Fuel Mont Cert /SB989 /Cath. Prot. $ 98 /hr (2 hrs minimum) _ $196 NOTE: $98 /hr for each type of test /per site /per UST system even if scheduled at the same time TT ❑ Oil well (Installation, Inspection, or re- inspection) X $ 98 /hr 84 ❑ Tent TENT $ 98 /hr ❑ 1 After -hours inspection fee 124 /hr 2 hrs minimum = 248 ❑ Pyrotechnic (1 permit per event, plus an inspection fee of $ 98 /hr + (5 hrs min standby fee /insp) _ $588 $98 /hr during business hours) PYRO NOTE: After hours Pyrotechnic event inspection is @ $124/hr 5 hrs min standby fee ins = 620 ❑ Re- inspection /Follow -up Inspection $ 98 /hr 84 ❑ Portable LPG (Propane): # of Cages? $ 98 /hr 84 ❑ Explosive Storage $ 241 84 ❑ Copying & File Research (File Research fee $51 /hr) $ 0.02 /page 84 ❑ Miscellaneous Site Plan Review (Carnival & Fairs /Vehicle $ 98 /hr 84 Dh;nleav/Motion Picture) FD2021 (Rev 07/18) Please make checks payable to CI OF BAKERSFIELD. NO CASH Please. Thank you. VONLY El PERMIT TYPE FEE CALCULATION TOTAL TREASURY DUE ACCT NO ❑ Alarm - New & Modification (minimum charge) FA $ 288 ❑ Over 10,000 sq ft $ 0 .0288 x sq ft ❑ Alarm - Minor Modification (Add 1 device /Relocation of 2 devices) $ 98 /hr (2 hrs minimum) _ $196 84 ❑ Sprinkler - New & Modification (minimum charge) FIRE $ 288 ❑ Over 10,000 sq ft $ 0 .028 x sq ft ❑ Sprinkler - Minor Modification ( <10 heads) $ 98 /hr (2 hrs minimum) _ $196 84 ❑ Commercial Hood (New & UL 300 Upgrade Modification) FHD $ 241 Additional Hood $ 59 /hood ❑ Commercial Hood - Minor Modification (add /move nozzle) $ 98 /hr (2 hrs minimum) _ $196 84 ❑ Spray Booth (New & Modification) SB $ 241 ❑ Aboveground Storage Tank (1 inspection per installation) AST $ 185 /tank ❑ Each Additional Tank $ 98/Tank ❑ Aboveground Storage Tank (Removal, Mod, or Inspection) ATR $ 112 /tank ❑ Underground Storage Tank (Installation /Inspection) NI $ 900 /tank ❑ Underground Storage Tank (Modification) MOD $ 900 /site ❑ Underground Storage Tank (Minor Modification) MTM $ 171 /site ❑ Underground Storage Tank (Removal) TR $ 587 /tank 0 Mandated UST Testing: Fuel Mont Cert /SB989 /Cath. Prot. $ 98 /hr (2 hrs minimum) _ $196 NOTE: $98 /hr for each type of test /per site /per UST system even if scheduled at the same time TT ❑ Oil well (Installation, Inspection, or re- inspection) X $ 98 /hr 84 ❑ Tent TENT $ 98 /hr ❑ 1 After -hours inspection fee 124 /hr 2 hrs minimum = 248 ❑ Pyrotechnic (1 permit per event, plus an inspection fee of $ 98 /hr + (5 hrs min standby fee /insp) _ $588 $98 /hr during business hours) PYRO NOTE: After hours Pyrotechnic event inspection is @ $124/hr 5 hrs min standby fee ins = 620 ❑ Re- inspection /Follow -up Inspection $ 98 /hr 84 ❑ Portable LPG (Propane): # of Cages? $ 98 /hr 84 ❑ Explosive Storage $ 241 84 ❑ Copying & File Research (File Research fee $51 /hr) $ 0.02 /page 84 ❑ Miscellaneous Site Plan Review (Carnival & Fairs /Vehicle $ 98 /hr 84 Dh;nleav/Motion Picture) FD2021 (Rev 07/18) UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING/ SB989 SECONDARY CONTAINMENT TESTING/TANK TIGHTNESS TEST AND FUEL MONITORING CERTIFICATION (Please note that these are separate individual tests and will be charged per separate type test accordingly.) PERMIT # ❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ TANK TIGHTNESS ® FUEL MONITORING CERTIFICATION BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phone: 661 - 326 -3979 • Fax: 661- 852 -2171 Page 1of1 ❑ SB -989 SECONDARY CONTAINMENT ❑ OVERFILL PREVENTION SITE INFORMATION FACILITY Bill Wright Toyota NAME & PHONE # OF CONTACT PERSON Summer Hankins 661 - 398 -8697 ADDRESS 5100 Gasoline Alley Drive, Bakersfield, CA OWNER NAME Bill Wright Toyota OPERATOR NAME Summer Hankins PERMIT TO OPERATE # # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO TANK # VOLUME CONTENTS 1 10,000 gal 87/ UNL TANK TESTING COMPANY TESTING COMPANY CONFIDENCE UST SERVICES, INC. NAME & PHONE # OF CONTACT PERSON Jessica Baker 661 - 631 -3780 MAILING ADDRESS 16250 MEACHAM ROAD, BAKERSFIELD, CA 93314 NAME & PHONE # OF TESTER OR SPECIAL INSPECTOR Aaron Perrigo CERTIFICATION # B47853 TEST METHOD ICC # 8485827 APP ANT SI NAT DATE 01/17/2019 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED BY DATE FD2095 (Rev 03/18) ~'" " , ,.. <T .... - 10/2G/2004 15:15 GG13252529 CAL VALLEV PAGE 02 MONITORING SYSTEM CERTIFICATION For U$fI ßJl All Jllrlsdictiol18 WUhilt the $1(Jla ,"Cul/filmi". ' Aut/rarity Cited; Chaplel' 6. i, He.(1llh Qnd Sqfrsty Code; Chapter 16. DivIsIon 3. ruJø 23, Californlo Code 0/ Rl!gltlQt/ons This form must be used to document lestlng and scrvicing of monitoring equipment, A separate certi.fication or report m.ust be prepared for each monitoring'systcm control panel by the technician who perform., the wClrk, A copy ordus rorm m~~t be provIded to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days oHest døte, A. Gene1'RI1n(ormoUQn Facility Nattie: ßlI' WY'ì~br TQYlJt~ Site Address: ~l n" G-fLSql<'" ~ 1P<y ar". fo'acili1}' Contact PerRon: Make/Model ofMQßitoting System: rJ.t Cøltt B. Inventory of Equipment Tested/Certified Check lilt ap rl> rlnte bosel to Indløle ~ eellie equlpØlc1 nø ededllervlced: Tnnk ID: ---' ~ Tank to: . f:i In.Ttlnk Onuging Probe. Model: -"~ C In-Tank Oauglllg Probe. Model: 151 Annulnr Spa«: or V(lult Sensor. Model: RfJi!I't'SWiH," C Annular Splice; or Vault Sensor, Modol: 55 I'iping SlImp / 1'rench Scnsor(s). Model: FJ.p#ri.-S..ft:r/f(J., [J Piping S\lIn'l1 Trench Sc:ns(lr(s). Model: C Fill Sumf! SCnsor(s}, Model: IJ Fill Sump SenRor(s). Model: It Mech¡mienll)~e I,eak Detector. Model: PU ild;Al/ltf.. ItJ~lf-ð a Mechanical Line T..ellk. Oetector. Model: C Electronic 1.lnc Leak Detector. Model: CJ Electronic Line Leak Dçtççtor. Modal: C Tank Overfill I lligh·...eyel Sensor, Model: 0 Tsnk Ovcrmll High.Level Scnsc>f. Model: Q Other s cci~ c !:Ii mont I and model in Section E on PlIgC 2). [J Other s ecify equlpmentl e I\J1d model In Secllon E on Page 2). Tonic. ID: Tank ID: Q In-1'Pn\o; Gpl1iin¡ Probo. Model: C In-Tank Oaugin¡ Probe, Mr;Jdol; [J Annular Space or Vault Sensor. Model: tJ Annl/I.t SpaOð øt Vaull $ensor. Mode1: C Piping Sum) I Trench Senso\'(s), Modçl: a PipIng Sump 11'rem:\¡ SCl1sor(¡¡). Model: CJ Fill Sump Scn!lOr(~). Model: C Fill Sump Scnsor(s), Model: a Mcchanlcol Line I..cnk I)(:tcc:tor. Model: QMecI,aniCIII Line l~k [Jetcctor. Model: a ßh:çtnmiç ..in!: I.ç¡¡k I)electot. MI,dcJ: Q mectronie Line Lenk IJclector. Model: o Tank Overlill/lligh.Levcl Sensor. Model: tJ "ank OVc:rOIlI nigh-Level Sensor. Model: C Other s~eclry c:qul111\Cnt type and model in Section ß on "II go 2). C Other (specil)l equipment type and Inoclel In Section ß on Page 2), blsp."nr 11): , 1)lspc\ser JD: II DI!If\cn~er Containment SC!1sor(s), Modd: ~f.J a Dispenser Conlninment Sensor(s)_ Model: (jf Shc:nr VnlvC\(s), --n;:¡¡r-¡'f C Shellr VIIvc(S). t1 Di looser Contnllunont Floo S 111111 (,.'háÌn s . Q DI cnsct Containment Ploat(s wId (,:hllln(s). Dispenser 10: Dfrpenler tD: a DlspønMr CoNtainMaNt ScI1110r{S). Model: C Dispcmer COhtmnment Sensor(s), Model: o Shent Valve(s). C Shear Valvc(s), [J bis cnser Contøinment Float(s) and Chaln(s), C Cis enser Containment FloŒ sand Chaln(s). ÞbpcDser 10: Dispenser JD: o IJlspcnaer <':Qnlninmenl SenlOr(5), Mooel: a Dispenser Conlainmcnt Scnsor(s}. Mode.l: a 8hctot Vlllvç{s), Q Sheor Valvc(s). CDispenser Conløinmctlt flool(s) and Chain s). C Dls nscr Containmenl Float(~) I1nd Chl1in(s , 'Jf ¡he Ðlcly C(ll1tallls more tnnlc$ or di$pcnsera. copy tllia forl11. Include Information for every tlln and ispen~ III the fnclllty, c. Certifi~ßtion " t ~ertify Ihnt tile equIpment Identtned In Cbb doeutlu:nt WIIS Inspecttd/!crvic\!d fn accorclAn~t ",iIIl the mønu(IIC!"rcrl' IJlllchrlln... "'ttlched Ca flrb Certification I. In(ormatloD (e... madalr"clure,..' checkU.tII) naCQlory to verity tlult Chi. InrorDlntiOtl hI &:.OTTlllet and It Pint Plan .bowfn, the IR;)'o\lt of monitorIal 8qulpm.nt. For ny I!r¡ulpment ~pble of EClJerøtlng such teJ'nrb. t hllve IIt~o nUodled n copy of th~ '/'ollort; (ØhéCk all dlat tlpplJl): tJ System sct-up 1:1 Ahum hbtory .-e1ort TechnicIan Nattie (print): -orCoLt:..~ lIi.t.rl<1l' Signature: ·~_~--HJ¡,...r/,.¡J(. Certification No.: ~~lfIf7~ License. No.: ----2§'t/7ø H !.iA.z, ~~ling Com pan}' Name: CAt-Va/If;' E!l"ir};z~1rl1- Phone NO.;( S~I L.327""""3'(/ )/te Address: S'"1t1Ø (;,;vðh'A 4! J4.lk./¿ efj'. ß¡tt/<'W.I,,.h'i.eIf'fr Ce.. DateofTestinglServjçjng: JLI.f2J rl , ¡ I, ;, ¡ -,i. J!' , I .... ~ Pate h 3 , I Cily: 8a.Kor,f"~'tlA' Ct'II\Ulct f'h(1ne No.: ( ~ Dale ofTc5tinglServicing: jJL}..i1..).Jl!L Bldg. No.: Zip: ~ònitor¡ng System Certification 113/11 t -; > 10/26/2004 15:15 6613252529 CAL VALLEV PAGE 03 I). Rtstllt,orTestinglScl-vic::iug Software Version Installed: III "I' ,:,ti:~i~ . ,,:¡:',::,)¡ , '!'~I'" i'!' . ',:..~ . .' "[,,, 1 . ~j ~. ~ ·t r ! . ", 'I' Complete tbe rollowlne; checklist: u g Yes C No· Is the audible alarm operational? ~ Yes C No· 15 the visual alarm operational7 aI Y cS 1:1 No· Were all sensors vlsuø.lly inspected, functionally tested, and confirmed opcratlonal? Qf Yes [J No· Were all sensors installed at lowest point ot'secondary çOl1taimnent and positioned so that other equipment will not interfere with their proper ODeration? ~ aVes a No' If alarms oro relayed to ( remote monltonni st.tiOh. IS nil çOmmunications equipment (e.g. modol") tø'. N/A operalional? : . I ; iii Yes a No· for pressuriu:d piping systems, does the turbine 8Utomatlcally shut down If the piping secondary containment C N/^ moniloring syslem deleçts a leak, fails to operate; or is electrically disconne.:tcd7 Jr yes: which tensors Initiate positive shut-down? (Check alllhal apply) J4.Sumprrrench Sensors; Of-Dispcnser Containment Sensors, Did )'ou confirm positive shut-down due tò ICikS and !Ientor failure/disconnection? CiF Yes; C No. [J Yes C No· For tank systems thut utilize the monitoring syøtèm as the prlmaTY tank overfill warning device (I.e. no tjir NI A .nechanlcal overfill prevention valve is int~Ued), Is the overfill warning alarm visible Bnd audible ot the tank nil point(s) and opcraling properly? If so, ahvhat Dcrc::ent of tank capacity docs the alarm tfluer? % [J Ycs· ØiJ N.D Was any monitoring equipment rcplaced? Ify!=S,:ldentity specific sensors, probes. or other equipment replaced IInd list the manufacturer name and model for all replacement parts in Section E, below. ~ Yes· tJ No Was liquid found inside any sccondary contúnment systems desl¡ned DS dry systems? (Checlr. all thaI (lpply) a Product; ø Water. Iryes, describe causes in Section E, below. :J Yes 1:1 No· Was monitoring system set-up reviewed to ensure proper settinas?, Attach 5et up rBþol1$. if applicable :J Yes 1:1 No' Is all monitoring equipment operational per manufacturer's specificl!tions? · In Section E billow, describe bow Rnd when thl!..~e deOdenclcs 1Vere.or will be eorredcd. ¡¡;. Comments: A (h1a./( 4tf):LIJ.W:IJ±-Cl-.LW~kH' WAJ------i't-~Ja. .Tt.t.... II"H~Jt/l.Y $iOAU,. .It" WAl Pvl"rJn( O~1'. ",:"",~,", ' I!,HJI~:I t.!;::,!; '.gUo' ¡,f". ,; I "Ii.. 1','!I'f; , ¡, ;., 1,,/ t" r' .\ ¡;.. , .,' ,., .. : . I;~' I,", 'I:, ¡ , ¡:: I : r ~ :: I: r 4:':" I : 031111 ~ .. 10/26/2004 15:15 6613252529 CAL VALLEV PAGE 04 F. tn-T~\Ut( Gouging I SIR E(ln¡"nu~ltt: íi!hCheck this box Iflnnk gauging is used only for inventory control, o Check this box ifno tank gaugine or SIR. equipment Is Installed. 111is $ectíOI1 must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the followina c cc 1St: DYes [] No· Has oil inp~t wiring been in!ipèc;ted for proper entry and termination, Including te-sting ror ground fault~? o Yes a No· Were ~1I tank gauging probes visually tnSPeçt.ed for damage end residue buildup? o Yes [] No· Was accuracy of system product level readin¡s tested? o Yes [] No· Was occuracy or system water level readines tested? o Yes [J No· Were all probes reinstalled properly? Q Yes (] No· Were ;llIllems on the equipment manufacturer's maintenance c:hcçklist completed? -. ' C . n~ r will be corrected. h kl' In the Section H, belòw. describe bow Rnd when tÞcse d nClc les were 0 G. Line Leak Detectors (LLD): ~ Choçk this box irLLDs arc not Installed. Complete thc follow 112 checklist: o Yes (] No· For e<\ltpment stnrt.up or annual equtpmcnt c::ertincation, was a leak slmûlnlcd to verify LLO '!erronnnncc? [J N/^ (Ch~r:k off ,/ral t'1PP/Y) Simulated leak rete: Ci-3 g,p,h.; t:J 0.1 g.p,l1; [J 0.2 g.p.h, tJt Yes 0 No· Were all l.1,Ds conf1nned operational and accurate within regulatory requirements? \IÐ Yes tJ No· Wns the testing apparatus properly calibrated? ,- ~Yes [] No* For mechanIcal LLDs, does the LLD restrict product flow ¡(h de,ects II leak? eN/A 1:1 Yes (] No· For electronic LLDs, does the turbine automatically shut off i r the LLD detects Bleak? ~N/A I:] Yes DNa· For electronic LLDs, do~ the turbine automatically shut off if ony porlion of the monitoring system is disabled W N/A or disconnected? aVes a No· For electronic LLDs. does the turbine automatically shut ofT if any portiol~ of the moniloring system or: N/^ Inalrunctions or rails 11 test? a Yes Q No· For electronic "'LD~, have oil accessible wiring connections been vIsually inspected? r.B' N/^ UiI YelJ I:J Nu" Were nil items CIII the cquipmcllt I1lunulìtcturcr's l11ßinlcnol1ce checklist coltlJlcted'l . .. In the Section H, below. describe bow ""d \Vbn these dencleneles were or \Vdl he corrected, H. Comments: rage30r~ . , OJIOI