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HomeMy WebLinkAbout2800 PANAMA Lane_UST FMC 5.20.11EM1111 ❑ Commercial Hood System ❑ <_ Fire Alarm System ❑ HOODS ALARMS SPRINKLER SYSTEMS SP MY BOOTH H AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. File Number: ��S-'SS'S Address: '-�$"©© ��,� 4-c,« ak L , Bakersfield, CA 933 Date Received: f/ Business Name: SYSTEM: BUILDING SQUARE FEET: INSPECTION LOG New Mod. ❑ ❑ Commercial Hood System ❑ ❑ Fire Alarm System ❑ ❑ Fire Sprinkler System ❑ ❑ Spray Finish System ❑ ❑ Aboveground Storage Tank ❑ ❑ Underground Storage Tank minor modification Underground Storage Tank removal Underground Storage Tank ❑ M,' Other: > -;'� c Comments: Building Sq. Feet: Calculation Bldg. Sq. Ft: 1. 2. 3. 4. Date Time Signature UNDERGROUND STORAGE TANKS BAKERSFIELD FIRE DEPT. B A R S P 1 1D' p�R� Prevention Services _ APPLICATION � aer� r B�O rsf eld, CA� o� —r TO PERFORM ELD / LINE TESTING Tel.: (661) 326 -3979 / SB989 SECONDARY CONTAINMENT TESTING Fax: (661) 852 -2171 /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION FAX E: ® Page 1 of 1 MAY 2 ®2011 7-771 PERMIT NO. mmomomm ❑ ENHANCED LEAK DETECTION ❑ LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT TESTING ❑ TANK TIGHTNESS TEST Q TO PERFORM FUEL MONITORING CERTIFICATION ,.x'- , ".`:•. ,mr,;a.e �`. :tom �:`r „•"- �.� "`- ':`.;': R,ss`. x t � •.:�*e • t .: ., .. ;. -o, x .. .... ... ..:........xz ..• , - ., .z;,. w . x -.__ e Y+ .bx`it .. : •,:t, eae^x. , �l �C11 FACILIT w kwp—� ! SSON AT D, !' lY ADDRESS . d J OWNERS NAME OPERATORS NAME, PERMIT TO OPERATE NO. NUMBER.OF TANKS TO BE TESTED .. IS PIPING GOING TO BE TESTED? ❑ YES ❑ NO TANK# VOLUME CONTENTS OnD u: i l06 TANK.TESTING..COMP<ANY¢ j, ��; -- NAME OF TESTING COMPANY Tanknolo Inc. 9Y� NAME & PHONE NUMBER OF Deanna Davenport CONTACT PERSON p 800- 666 -1130 MAILING ADDRESS 41785 Enterprise Circle S. Suite D Temecula, CA 92590 1A A NAME & PHONE NUMBER OF TESTER OR SPECIAL INSPECTOR: yvr� r CERTIFICATION #: DATE & TIME TEST TO BE �' ' CONDUCTED: ICC #: v(� lo�2-- U: METHOD SIGNATURE OF APPLICANT DATE: '� n APPROVED B DATE W1 a <, 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 i UST REMOVAL DESCRIPTION DATE SIGNATURE EVR UPGRADE MISC. ACTIVITY REMARKS: AST NEW INSTALL DESCRIPTION DATE SIGNATURE MODIFICATIONS MINOR / MAJOR AST REMOVAL DESCRIPTION DATE SIGNATURE PRIOR TO OPERATION OF ANY SYSTEM, ALL UST AND /OR AST SYSTEMS SHALL BE INSTALL, COMPLETE AND ACCEPTED BY THE BAKERSFIELD CITY FIRE DEPARTMENT. FIRE DEPARTMENT (FINAL) BUILDING ADDRESS: JOB DESCRIPTION: C_. OCCUPANCY TYPE: OWNER: PERMIT NO. CONTRACTOR: I p, K,n�d�ij PHONE if FD 1743 External Certifications Internal Certifications Date Completed Due Date Cert # Date Completed Due Date OPN -Tank Gauges EECO 1500 . :. 1 ;; :: .312212012 "': OPW=- :PFiase :l EVR . ,1128/2010- `1128/2012:= TLDs.1_. , -.. " : 3/231201,1; " ;: 3/22/2014i" Veeder.R06t Red JacektCPT :636644. ..`.'2126J201Q; - �2i25i2012 „` . Sta " " "'e'll Weder Ro6t;Red Jacket LD;:.. ' : ; : :. :: .936644 ;` 8L18J2009 :,' 7 :;8ie1 °812011 S . ill° Container::.` ;'.4/5/2010,,;_; ;',':414/2013 Veeder Root 2 -3 636644 FTA : °,: ,a ; °� ,4/5/20,1 __: 4/4/2013,, -' -, ' � :.636644;, ' °619210 _ , 43/201>1.;, Veede•r;R66t.V60 6('Rroducts :., ". ; . :.1336644 . -` "3115 =1, 1 ' ._:_3/15/2013--` BottoM,-Flattness ::'41512070;:, „ .:4/412013 , V$T EVR; ". :.t - : -� ; =; __� ; < ; : : :�: ;; :. :.: - •.,1,41'4` :: �12/28/2010�= "j-2/28/2012: IVacutkbtl : :... ;.. : :,::9 /15/20:10 =::° < :' :9/14/2013' =' SCAQMD�- w e 2 ., P :V-VentZap •: , : ° ` ":4/5/2010 :; . :.' 4/4/2013:;,"' A09048, ^:::: 6%19 /2009:. = .`- : �`N /A' -i;� . UST X101 ' ., •. : : :� : ;,;. „4/5/2010::.F : :.4/212020 " = s�Qa ulr��Gt7F° SJU t�9. , 611�120t78 " ", . �2l24`'0 . 2936053761.- ;. 5 /8/2010.;:` . :;: 5 /8120:12;::" Phil- Titer:,F., - 293605376,1 ,: '5/8/201,0 `.;. X5/8/2012 674,C-1° ;:12/16/2008;; 4;12/15/2013'/ T405.',- :. ::7/23/2009= : X7/23/201 . Beaudeau :400 =500'; , _` ::; S1. =730 : s , : -7/3 :1/2009_ Z/31/20a1;1; :: E=415i; ; � > /;7/22/2010; : `:7722/20.12', Incon =¢ FMS .aevel = :1 :'Installation °.;; ;.. .6866873702"_ ' 111714/2010;; ._:1:1114/2012;: Incon:= `FMS":level;2 -;P- ro "ra'm—m-in : " .6866873702 :;1:1/.14/20;10.; - ° == 11/14/20.12. °: . Incon• -: FMS level13 Leak detection Incon - FMS level 4, Sump Test Opr lhc6n'VRM 1e9e1=5:in s4dia -686687,3702- - X1,1114/2090,; ,'741/14/2012= 76081003: ' 10/6/20,10,'4 , VR Pswd IGC; =;DesO rs ?: ; : _; ? :_ : : :. :_ ;: ;: •';':::: °`;3/25/2010;:? 3/25/2012:: FF Pswd . ` - ICC ':8014682 =17.T :-`625/20:1& 1': 6/25/2012: ° - API Pswd - ICG '�VaporRecove . ;Installers 8009647 =VI, .'';:2/19/2Q1;0:: - ;1__2/_19/2012::: ICC ICCa= rVa °por�Reco,ve 'T.est; &`Repair -,: '�' t , 2/24/2010;' , =2/24/20,12H" ICG;U3�Tanktightnessae'stin E`::` f; -�. :. :;� • ARI _;:;' 60650123;`: - :;1/31/201:1: ..;... X2/8/20 :12, Blueline CA Water Res: Control Boar "d:::::.:::::. 10= 1,751: -; ';12/10/2009,•: ;- =1131/20.13/ �; VM1= _Vaporless Tankn6lo =. ;.. 18 :13.?r.'. :,`5/3%2010" 7x_,':.5/3/2012' :r Omntec Clark GountyStagell'° << k �, 4rizoriaWeigfits�and�lVleasures �165(IRSR� $f26120U.9 � eva� a; -- °; EMCO Phase 11 EVR (HIRT) TANKNOLOGY TESTING NOTIFICATION . Southern California.Reciional Office Tanknologv Corporate Headquarters 41785 Enterprise Circle South, Suite D 8501 North MoP.ac Expressway, Suite,400 Temecula,, CA. 92590 Austin, TX' 78759 951 - 676 -4060 512 -451 -6334 806- 666 -2176 800- 800 =4633 951 - 676 -4061 Facsimile 512 -459 -1459 Facsimile TO: City of Bakersfield E -MAIL: www.ci.bakersfield.ca.us Fire Department E -MAIL: TELECOPY. NO. 661 -852 -2171 . FROM': Deanna Davenport E -MAIL: ddavenport@tanknology.c6m DATE: 5/20/2011 TIME: No. OF PAGES INCLUDING COVER:.., =. 1 .ORIGINAL TO- FOLLOW: No: COMMENTS:.." Tanknotogy will be at.the following locations: DATE TIME SITE AND ADDRESS 'TEST TYPE 06/02/11 09:00am Sayegh Group Inc., 2800 Panama Lane, Monitor Cert, Leak Bakersfield, CA 93313 Detector. and Spill 661- 835 -0643 Bucket Testing t; 7 E_ U Tankhology, Worldwide Leaders in UST Compliance Testing CONFIDENTIALITY NOTICE - This message is intended for the use of the individual or entity for .which it is addressed and may contain information that is legally .privileged „_confidential, and exempt from disclosure. If the reader of this messaage is not the intended recipient, you are hereby notifiedthat any .dissemination, distribution, or copying of this communication is strictly prohibited. If you received this communication in error, please notify us immediately by telephone to arrange for the return of the original. material. CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES B E R S P I D 1501 TRUXTUN AVENUE, 1sT FLR PIBE BAKERSFIELD, CA 93313 ARTM T Office Phone: (661) 326 -3979 Application Number . . . . . Property Address . . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . Owner ------------------------ SAYEGH GROUP INC PO BOX 4917 SAN DIMAS CA 91773 11- 10000184 Date 5/26/11 2800 PANAMA LN 372 - 410- 08 -00 -5 FIRE DEPT 0 Contractor ------------------ - - - - -- OWNER -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Permit . . . . . MANDATED LEAK DETECT TEST Additional desc . . Phone Access Code . 1100361 Permit Fee . . . . 96.00 Plan Check Fee - 96.00 Issue Date, 5/26/11 Valuation . . . . 0 Expiration Date 11/22/11 ---------------------------------------------------------------------------- Fee summary Charged Paid ' Credited Due ----- ---- -- - - - - -- --- - --- --- -- -- - - - - -- ---- - - - - -= ---- - - - - -- Permit Fee Total 96.00 96.00 .00 .00 Plan Check Total 96.00 96.00 .00 .00 Grand Total 192.00 192.00 .00 .00 CALL FOR INSPECTION (661) 326 -3979 Please state the Permit Number, the Job address, and the Type of Inspection. Requests for inspections should be made at least 48 hours in advance. DECLARATIONS Permit is issued in accordance with all applicable Federal, State and Local Ordinances. The permittee has properly signed and dated the reverse side of this form. This Permit expires afterl80 days of inactivity. I have reviewed the above application, and find it to be correct/complete. Permittee: Date: 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 Agen 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 Date WORKERS COMPENSATION DECLARATION I hereby affirm that under penalty of perjury one of the following declarations: Carrier 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: 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 1 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. Signature of Applicant or Agent I I Date