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Home My WebLink About2300 WHITE Lane_UST REMOVAL 1.21.10 WALMARTHOODS ALARMS -SPRINKLER SYSTEM'S SPRAY BOOTH AST usl Permit No. Permit No. in�u� oa 1E. 07 File Numbers 35_ z f Date RO Cd, iVed.'. : - _?f - New Mod. ❑ 11 , Commercial Hood System 0 0 0 minor modification (� removal Ffirfe'AlAr S y AM Filre Sprinkler System Spray Finish 4yat6m Abbveground Storage Tank Underground Storage Talhk Unde"t'grou,nd Storage Tank Underground .Storage Tank 0 ❑ Other Comments: Permit No. Permit No. Permit No. Permit No Address: Business Name: X:e ufj . I Y� I -V V __ f3 ui I d 1 S, q : Feet: 4K Calculation Bid"'g . SqiFt: 4. 4igbaitutd S kg ' na ure i�� oa 1E. BAKERSFIELD CITY FIRE DEPARTMENT — INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work Inspection Reouest Phone No. (661) 326 -3979 DESCRIPTION DATE SIGNATURE BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF DESCRIPTION DATE T4,1111, TESTIVG_ MODIFICATIONS MINOR/ MAJOR AST Mn All DESCRIPTION DATE SIGNATURE ^'LtW,u0 L J36 T_r_w S L 24- /10 PRIOR T_O.OP-ERATION -OF ANY SYSTEM, ALL UST_ANDIOR AST SYSTEMS SHALL BE .INSTALLED, COMPLETE AND ACCEPTED BY\ THE BAKERSFIELD CITY FIRE DEPARTMENT. 1114 � BUILDING ADDRESS 4NO k-% T JOB DESCRIPTION JOCCUPANCYTYPE OWNER t J - -W^- r PERMIT NO. 621;r CONTRACTOR -.7Q C e. 'B a.Y- -v-vf�o r✓ PHONE # '5V7- 6-066 FD 1743 HAZARDOUS MATERIALS STATEMENT _ Yes — No Will the applicant or future occupant handle hazardous material or a mixture containing a hazardous material equal to or greater than the amounts specified on the list of extremely hazardous substances? See checklist for guidelines. _ Yes — No Will the proposed building or modified facility be within 1000 feet of the outer boundary of a school? _ Yes — No Will the intended use of the building by the applicant or future building occupant require a permit for construction or modification from the Kern County Air Pollution Control District ( KCAPCD) or from the Bakersfield Fire Dept? See checklist for guidelines. —Yes—No I have read the Hazardous Material Guide and KCAPCD Permitting Checklist. I understand my requirements under the Calif. Health and Safety Code Sec. 6.95 and Calif. Govt. Sec. 65850 and the requirements of the City of Bakersfield Fire Dept. regarding hazardous materials. Owner or Authorized Agent _ .�� _ hone No. Date DECLARATIONS: The declarations below are mandated by the State of California under Section 19825 of the Health and Safety Code. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions'of Chapter 9 (commencing with Section 7000) of the Division 3 of the Business and Professions Code and my license is in full force and effect. Lic. Class Lic. No. Exp. Date Contractors Signature Date OWNER- BUILDER DECLARATION I hereby affirm that under penalty of perjury that I am exempt from the Contractors License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 commencing with Section 7000 of Division 3 or the Business and Professions Code); or that he or she is exempt there from and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)): I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044 Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner - builder will have the burden of proving that he or she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon and who contracts for such project with a contractor(s) licensed pursuant to the Contractor License Law). I am exempt under Sec. B: & P. C. for the reason Owner Signature ONNA W-00 Iffid - _ Date WORKERS COMPENSATION DECLARATION I hereby affirm that under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self - insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. . I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy No. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code. I shall forthwith comply with those provisions. Applicant: Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,•AND SHALL SUBJECT AN EMLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000) IN ADDITION TO COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the.work for which this permit is issued (Sec. 3097 Civ. C.) Lenders Name Lenders Address I certify that I have read this application and state that the information contained herein is correct. I agree to,comply with all city ordinances and state laws relating to building construction and hereby authorize representatives of the city to enter the above mentioned - property for inspection purposes. 51 011 WERE Signature of Applicant or Agent "_ Date ABOVEGROUND STORAGE TANK �Si- APPLICATION FORM ARrAF r INSTALLATION /REMOVAL OF AN AST INSTALL ® REMOVE PERMIT # BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Ave 1sT FLR Bakersfield, CA 93301 Phone: 661- 326 -3979 ? Fax: 661- 852 -2171 Page 1 of 2 FACILITY NAME OEM ADDRESS OPERATOR NAME PERMIT TO OP RATE # J 0D OWNER NAME # OF TANKS TO BE INSTALLED 4— /REMOVED yFe3 "'SA"k 2N`':k: �f ��' F 1- �ph h""+rtff� f'yt+�F F+%:f 'Y } G44'r S'. *•C�� fiz`a ': � $'� '�4'�* ��. ?� � _ I y"� xjzv"k ` -s/.ah .T'f "k'i IF -2 } � 'c `�a � -: x� 'y.l �y 'i. - ��"`Jfi>"i �lri!'+ �. 4F,iL 'r :x n�v �,. .. T, "�`n( 1F } �vfwuE 7"}4C1 wfl, .si�'x Fs��.k , :3 Y .,5 <.7 � zT,�. :�nl. Si . „x4.�_ „�l<} .ry �A._a_ 'w.a j�n.7s;3 _ii�u �i�.4k�,1.� n �ff%. i� , dt .fl}T >.- .f, A*.x�,. _..Liir✓ Fa� rr.V. i Z Mproe LiW NAME OF COMPANY INSTALLING AND /OR REMOVING TANK MAILING ADDRESS NAME & PHONE # OF CONTACT PERSON DATE & TIME TANK IS TO BE INSTALLED / REMOVED SIGN OF APPLICANT DATE APPRO0Y (�_cJ1 DATE FD2081 (Rev 01/08) i ABOVEGROUND STORAGE TANK GUIDELINES FOR PERMIT TO INSTALL /REMOVE AST FOR DISPENSING OF FLAMMABLE OR COMBUSTIBLE LIQUIDS AND CONDITIONS FOR CLOSURE, EXCAVATION REMOVAL & DISPOSAL, SOIL SAMPLING, PRELIMINARY SITE ASSESSMENTS B B R S F I D FIRE A' R fM T GUIDELINES FOR PERMIT TO INSTALL AN AST FOR DISPENSING OF FLAMMABLE OR COMBUSTIBLE LIQUIDS BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Ave 1sT FLR Bakersfield, CA 93301 Phone: 661-326-3979 ? Fax: 661-852-2171 Page 2 of 2 1. Any aboveground storage tank installed within the City of Bakersfield for the purpose of dispensing motor vehicle fuels must meet, the requirements of Section 5202.3.7 of the California Fire Code, 2001 Edition and Bakersfield Municipal Code. 2. The tank sizes shall not exceed a capacity of 2,000 gallons individual or 4,000 gallons aggregate. 3. Any aboveground storage of petroleum with a cumulative capacity of more than 1,320 gallon must complete a Spill Prevention, Control and Countermeasure (SPCC) Plan, per California Health & Safety Code Division 20 Chapter 6.67. A copy of this plan must be submitted to the Bakersfield Fire Department Office of Prevention Services located at 1501 .Truxtun Avenue, Bakersfield, CA 93301 and can be reached at 661 - 326 -3979. APPLICATION PROCESS 1. Provide two sets of a plot plan for the facility. This plan must include location of property lines, all buildings and openings to each building (i.e_ windows, doors, vents, etc.), nearest road or Intersection, all tanks piping, any fixed source of ignition (i.e., water heaters, forced air, AC units, etc.), all foundations, and equipment to be installed. 2. Construction details of tank pad seismic straps or fixtures, and crash posts. 3. Certification by the manufacturer that the tank meets the applicable codes. 4. Identification of the material to be stored in the aboveground storage tank. 5. Building permits for all reinforced concrete and electrical work must be obtained at the Bakersfield City Building Department located at 1715 Truxtun Avenue, Bakersfield, CA 661- 326 -3720. Construction cannot begin without their approved permit. 6. Complete any necessary application for the Air Pollution Control District for any storage or dispensing of gasoline or aviation fuel. 7. Applications must be fully completed or they will be returned - no exceptions. 8. Permit fee must be submitted with the application or the application will not be processed. 9. A final inspection must be completed before AST system is operational. This is to ensure compliance with the UFC regarding placement of placards, and where applicable, the testing of emergency shut -off device, and overfill /overspill. GUIDELINES FOR PERMIT TO REMOVE AN AS I. Tanks may not be removed without an inspector present. 2. Tanks shall be either decontaminated or transported as hazardous waste. 3. A Hazardous Waste manifest will accompany either the rinseate or the tank and shall be present on site and presented upon request. 4. The interior of tanks being transported not as hazardous waste (decontaminated) shall have a lower explosive limit (LEL) of no greater than 5 percent immediately following cleaning and prior to the introduction of carbon dioxide (COZ). 5. The contractor shall certify on the inspection form that the cleaning process was properly conducted and the LEL results did not exceed 5 percent. 6. The decontaminated tank shall be inerted with the introduction of COZ, in the form of dry ice or from canisters. 7. A rate of 20 pounds of dry ice to 1,000 gallons of tank capacity, or the corresponding weight of COZ. 8. If canisters are used, they shall be bonded to the tanks. 9. A receipt for the COZ shall remain on site and presented upon request. 10. Prior to the removal of a decontaminated tank the LEL level will be no greater than 5 percent and the oxygen level will be no grater than 9 percent. SOIL SAMPLING/ PRELIMINARY SITE ASSESSMENT Soil samples shall be obtained under the direction of a professional engineer, geologist, or authorized representative of a State- approved laboratory. Samples shall be collected, at a minimum, from depths of 2 and 6 feet below the tank bottom, dispensers, and product lines and from the following locations (unless waived by the local agency inspector on site): A. From the center of the tank. B. Below all dispensers. C. Piping - every 20 feet and /or at connections, joints, bends, etc. Any area of obvious contamination of likely areas of contamination may be required to be sampled. All samples shall be analyzed by a State - certified laboratory. Soil samples shall be analyzed for all known and suspected substances to have been stored in the tank. Additionally, methyl tertiary butyl ether (MTBE) shall be analyzed in all soil samples taken from beneath tank systems which contained any motor vehicle fuel. All samples will be accompanied by a Chain -of- Custody sheet. A soil sample report/preliminary assessment shall be submitted to the Office of Prevention Services within 5 days after results have been received and shall contain at a minimum the following information. A. Name and location of where tanks were disposed. B. Name and location of where rinseate was disposed. C. A signed copy of the Hazardous Waste Manifest. D. A tank disposal receipt from the scraping facility. E. Copies of all lab data sheets and Chain -of- Custody documentation. F. A plot plan showing the location of buildings, tanks, piping runs, dispensers, and ALL SAMPLE LOCATIONS WITH CORRESPONDING I.D. NUMBERS AND DEPTHS. FD2081 (Rev 01/08) BILLING & PERMIT STATEMENT BAKERSFIELD FIRE DEPARTMENT E B S F, D Prevention Services PERMIT # FlirE 1501 Truxtun Avenue, 1st Floor aesir r Bakersfield, CA 93301 Phnna• F,F,1 = R7F, -IQ7Q . Fay- F,F,1 -R97 -7171 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK. ❑ Alarm - New & Modification (minimum charge) $280 ❑ LOCATION OF PROJECT SITE 2� L INFORMATION PROPERTY OWNER STARTING DATE Sprinkler - New & Modification (minimum charge) COMPLETION DATE NAME PROJECT NAME Over 10,000 sq ft $0 .028 x sq ft ADDRESS PHONE # PROJECT ADDRESS • Minor Sprinkler Modification ( <10 heads) $96 (inspection only) CITy P�.4K1- iRiS�IELp STATE C'A ZIP CODE CONTRACTOR NAME i'?cN i�LL • IY3 yw1- CA LICENSE # •' INFORMATION TYPE OF LICENSE EXPIRATION DATE PHONE # CONTRACTOR COMPANY NAME ❑ Additional hood FAX # ADDRESS ❑ CITY ZIP CODE 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 • Minor Sprinkler Modification ( <10 heads) $96 (inspection only) 84 ❑ Commercial Hood (New & Modification) $470 ❑ Additional hood $58 ❑ 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 t° Ce (c7ZS 8 ❑ 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 Leak Detection (test) /Fuel Mont Cert/SB989 NOTE: $96 /hr for each type of test/per site even if scheduled at the same time TT $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 4 Cityy of gAersfield i # C- STOMER RECEIPT *f* . C 11Per= O PRRUQ. Type: CC i,?rawer: 1.:' .;. �t�.::•iia?1l1, Receipt. no: 65479' ` f Lis+ ripLinn tlu.Rrrtata '" t�mount, i Cif BUILDING F'EFAI (S t .3 $4,60 Temten °det�il� :ten are $4,J6. 00 , irao� cage file: wb "kF1!i Y H(ILIDA�g4 ' i