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Home My WebLink About3221 H Street_UST FMC 9.24.10File Number: 31 Date Received: 47 Address: 32 2 / S ;�/-, Bakersfield, CA 933.-.. Business Name: AZ" ❑ D' Other: 74--f L. Comments: 1. 2. 3. 4. INSPECTION LOG Date Time 0 1 78 IE- aignazure Signature SYSTEM: BUILDING SQUARE FEET: New Mod. ❑ ❑ Commercial Flood- System Building Sq. Feet: ❑ ❑ Fire Alarm System Calculation Bldg. Sq. Ft: ❑ .❑ Fire Sprinkler System ❑ ❑ Spray Finish System ❑ ❑ Aboveground Storage Tank ❑ ❑ Underground Storage Tank minor modification Underground Storage Tank removal Underground Storage Tank ❑ D' Other: 74--f L. Comments: 1. 2. 3. 4. INSPECTION LOG Date Time 0 1 78 IE- aignazure Signature UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD / LINE TESTING / SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. �. P g ,R S..F. ._ D P/RQ D' IARrm T BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326 -3979 Fax: (661) 852 -2171 Page 1 of 1 .ES ENHANCED LEAK DETECTION LINE TESTING g SB -989 SECONDARY CONTAINMENT TESTING JK TANK TIGHTNESS TEST ES TO PERFORM FUEL MONITORING CERTIFICATION FD 2095 (Rev. 09/05) SITE INFORMATION ' FACILITY Pacific Bell Telephone Co. dba AT &T California NAME & PHONE NUMBER OF CONTACT PERSON Grant Armstrong (661) 327 -6903 ADDRESS 3221 South H Street OWNERS NAME Pacific Bell Telephone Co. dba AT &T California OPERATORS NAME Julie Khdryan PERMIT TO OPERATE NO, NUMBER OF TANKS TO BE TESTED IS-PIPING GOING TO BE TESTED? a YES NO TANK# VOLUME CONTENTS SA098UO01 6,016 Gallons Diesel TANK TESTING COMPANY NAME OF TESTING COMPANY Tait Environmental Services, INC. NAME & PHONE NUMBER OF CONTACT PERSON Matt Denison (714) 345 -8080 MAILING ADDRESS 2131 South Dupont Drive, Anaheim CA 92806 NAME & PHONE NUMBER OF TESTER OR SPECIAL INSPECTOR Paul McLane CERTIFICATION #: Incon TS -STS 3356213761 DATE & TIME TEST TO BE CONDUCTED ICC #: 5283651 -UT TEST METHOD SIGNATURE OF APPLICANT DATE 0 9 / 2 3 / 2 010 ISM APPL QATIONZECOMES A PERMIT WHEN: : P , >ED APPROVED B DATE S-30 — /D FD 2095 (Rev. 09/05) CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES R s F l r 1501 TRUXTUN AVENUE, 1sT FLR FIRE BAKERSFIELD, CA 93313 4RYNITY Office Phone: (661) 326 -3979 Application Number . . . . . 10- 10000312 Date 9/30/10 Property Address . . . . . . 3221 S H ST ATN (11 Digits): 023 - 172- 20 -01 -8 Application type description. FIRE DEPT Subdivision Name . . . . . . Property Use . . . . . . . . Application valuation . . . . 0 Owner Contractor PACIFIC TEL & TEL CO OWNER 140 NEW'MONTGOMERY ST .# 818 SAN FRANCISCO CA 94105 (800) 303 -3000 ---------------------------------------------------------------------------- Permit . . . . . . 'MANDATED LEAK DETECT TEST Additional desc . . Phone Access Code 1037449 Permit Fee . . . . 96.00 Plan Check Fee 96.00 Issue Date . . . . 9%30/10 Valuation . . . . 0 Expiration Date . . 3/29/11 ---------------------------------------------------=------------------------ 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 Sensing tfw eommunjt4 Since IS 7 7 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. Scott Johnson _ Foreman Tait Environmental Services U.S.T. Construction • Compliance • Maintenance 2131 South Dupont Drive Anaheim, California 92806 714.560.8222 main 714.920.5479 mobile 714.978.2615 fax sjohnson @tait.com 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: Bakersfield Fire Department Esther Duran Fire Prevention Officer v r 2101 "H" Street • Bakersfield, CA 93301 661.326.3658 • 661.852.2171 -Fax Email• eduran@bakersfieldfire.us Sensing tfw eommunjt4 Since IS 7 7 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. Scott Johnson _ Foreman Tait Environmental Services U.S.T. Construction • Compliance • Maintenance 2131 South Dupont Drive Anaheim, California 92806 714.560.8222 main 714.920.5479 mobile 714.978.2615 fax sjohnson @tait.com 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 Agent[ Phone 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 I Date i 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 6`f'the ,"w"ork1forw,hich this permit is issued. I have and will maintain workers' ?`coiripei satiiin'insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this perm if`is'issueds : Mysworkers ',,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 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 Date BAKERSFIELD CITY FIRE DEPARTMENT — INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work InSDection Reauest Phone No. (661) 326 -3979 . AST- S ALL DESCRIPTION DATE SIGNATURE (P_RIOR T OPERATION- OF ANY SYSTEM, ALL UST AND /OR.AST- SYSTEMS_SHALL-BE CINSTALLED,- COMPLETE AND ACCEPTED By,, T,HE_BAKERSFIEL"D CITY,FIRE _DEPARTMENT: FIRE DEPARTMENT FINAL - ------ -` -- _ 5. 5T. DESCRIPTION DATE SIGNATURE BACKFILL CONTRACTOR PHONE # 7/ - Q- PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT, SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF 1 AST- S ALL DESCRIPTION DATE SIGNATURE (P_RIOR T OPERATION- OF ANY SYSTEM, ALL UST AND /OR.AST- SYSTEMS_SHALL-BE CINSTALLED,- COMPLETE AND ACCEPTED By,, T,HE_BAKERSFIEL"D CITY,FIRE _DEPARTMENT: FIRE DEPARTMENT FINAL - ------ -` -- _ 5. 5T. JOB DESCRIPTION 4, i C-- OCCUPANCY TYPE OWNER 4 T T PERMIT NO. /0 - 166 31 -Z- CONTRACTOR PHONE # 7/ - Q- QC� FD 1743 UST NEW I bLQLTMALL DESCRIPTION DATE SIGNATURE BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT, SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF. i ;RIPTION VIR (P_R161110 :CPERATIOWOF ANY SY9IEM, - - -- - -- ALL_U.STANII /oft AST SYSTEMS_SHALL -B ANSTALLED; COMPLET -E-AND ACCEPTED BY MISC. ACTIVITY T,HE:BAKERSFIEL "D" -CITY FIRE DEPARTMENT-1 FIRE DEPARTMENT FINAL" - - -�- 5. 5T. JOB DESCRIPTION tM C.. OCCUPANCY TYPE OWNER 4 T T PERMIT NO. /6 -100 3/7Z- CONTRACTOR q; ! PHONE # 2111- 666-%46 FD 1743 BAKERSFIELD CITY FIRE DEPARTMENT — INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work InsDection Reauest Phone No. (661) 326 -3979 UST L DESCRIPTION DATE SIGNATURE BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT, SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF F OPERATION_OF ANY-SYSTEM, ND /OR.AS SYSTEMS_SHALL -6EZ D; COMPLETE AND ACCEPTED BY RSFIELD "CITY_FIRE DEPARTMENT: - - - -- - -- . ST: BUILDING ADDRESS 7,77" DESCRIPTION vt� C. OCCUPANCY TYPE NER % T r PERMIT NO. 16-/66 3/ Z NTRACTOR Ai ! PHONE # 21 dl'- OIL FD 1743 Account Number: 03026 TAIT ENVIRONMENTAL SERVICES, INC. P.O. Box 11118 • Santa Ana, CA 92711 -1118 092310 1 9/23/20'10 r� 042359 ♦ PLEASE DETACH AND RETAIN FOR YOUR RECORDS 0 9341 I" i UT 192.00 TAIT ENVIRONMENTAL SERVICES, INC. P.O. Box 11118 • Santa Ana, CA 92711 -1118 o� 7- 7sJ9971 7 / ti,d. Tait Environmental Services UST Construction • Design • Maintenance Compliance Transmittal Fed EX Number: 7939 5032 5339 TO: UST Compliance Department FROM: Matthew Denison COMPANY: Bakersfield Fire Department PHONE: 714 - 560 - 8200x404 FAX: 714 - 978 -2615 1501 Truxtun Ave. Bakersfield, CA 93301 FAX: 661- 852 -2171 DATE: 9/27/2010 RE: AT &T Triennial SB989 Testing GEO: SA098 Hello. Tait will be on -site at the date and time indicated below in order to conduct the Triennial. SB989 Test. Following this cover sheet will be the application and.check in the amount of $192.00. Please contact me with any questions and /or comments., AT &T 3221 South H . Bakersfield 93301 10/06/2010 9:.00am Street CA Lic #588098 - AZ Lie #095984 - NV Lic #0049666 2131 South Dupont Drive • Anaheim, California 92806 • 714.560.8222 • 714.685.0006 Fax 11280 Trade Center Drive • Rancho Cordova, California 95742 • 916.858.1090 • 916.858.1011 Fax www.tait.com