HomeMy WebLinkAbout4013 H Street_UST MINOR 3.21.11111111
23
❑ ❑
Fire Alarm System
HOODS ALARMS SPRNKL ER SYSTEMS SPRAY [BOOTH ASS' UST
Permit No. Permit No. Permit No. Permit No. Permit No. Permit No.
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File Number: 3pzz Address: Zl^i3 45 ,
Bakersfield, CA 933
Date Received: g-21— i/
Business Name: -FA$ r. Q
SYSTEM: BUILDING SQUARE FEET: J INSPECTION d. ®G
New Mod.
❑ ❑
Commercial Hood System
❑ ❑
Fire Alarm System
❑ ❑
Fire Sprinkler System
❑ ❑
Spray Finish System
❑ ❑
Aboveground Storage Tank
❑
Underground Storage Tank
min r
modification
Underground Storage Tank
removal
Underground Storage Tank
❑ ❑ Other:
Comments:
Building Sq. Feet:
Calculation Bldg. Sq. Ft:
1.
2.
3.
4.
Date Time
Signature
3/21/20411
Original Amt. Balance Due Discount
334.00 334.00
Check Amount
1664
Payment
334.00
334.00
334.00
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Citti of PAers.field
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$167.09
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$167.439
!e ^der detail.
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$334.9y!
= 1'a #al t� fldered
634. U
,papprit
lrat15 date: 3i� I Tine; .i':L ;17
r�MSFE :� PA Y W40 NEVER
3/21/20411
Original Amt. Balance Due Discount
334.00 334.00
Check Amount
1664
Payment
334.00
334.00
334.00
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979 . Fax: 661-852-2171
Page 1 of 1
IPermit #
TYPE OF APPLICATION: ❑ NEW TANK INSTALL/NEW FACILITY ❑ NEW TANK INSTALL/ EXISTING FACILITY
(CHFC IC nNIP ()NI V\ rl MC)r1TFTCATT('1N OF FACTI TTY 61" MTNCIR monTFT('ATTCIN (lF FACT[ TTY
STARTING DATE/ ,
PROPOSED COMPLETION DATE ,,
FACILITY NAME
/ a
EXISTING' FACILITY' PERMITv #:,'- ` -•.:.. ' . ' " "' _' `"
FACILITY ADDRESS
=4,--)
ZIP-CODE
TYPE OF BUSINESS/-) APN #
Ukr /
TANK OWNER PHO E # y
ADDRESS i
C
7jR CODE
CONTRACTOR ' ,'
CA LICENSE.#
ICC #
ADDRESS
/ GC
C
ZIp:�O�E_.
PH NE ;c l
BA SFIELD CICY BUSINESS LICENSE #
lei
KMANS,COM/P�#
INSURER
BRIEFLY DESCRIBE THE WORK TO BE DON
WATER TO FACILITY PROVIDED BY
< r
DEPTH TO GROUND WATER
SOIL XPECTED AT SITE
# OF TAX(�,T BE INSTALLED
10
ARE THEY FOR MOTOR FUEL?
❑ YES ❑ NO
SPILL PREVEN14ON CONTROL AND COUNTERMEASURES PLAN ON FILE?
YES ❑ NO
THIS SECTION IS FOR STORAGE TANK IDENTIFICATION
TANK #
ke �a
VOLUME' e;
UNLEADED
REGULAR
PREMIUM
DIESEL
OTHER
_
r _
f
,
Tank Testing Company
NAME OF TESTING COMPANY
PHONE NUMBER
MAILING ADDRESS
NAME OF TESTER
ICC#
THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS
PERMIT AND ANY OTHER STATE, LOCAL, AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER
PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT.
NAME OF T ER
7 T 0-<, .4 6e
ICC#
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
FOR OFFICIAL USE ONLY
D APV OVED
A ROVE
rotune (Kev ualuy)
BAKERSFIELD CITY FIRE DEPARTMENT -- INSPECTION RECORD
Post this Card at the Job Site and DO NOT Remove for Duration of Work
Inspection Request Prone No. (661) 326 -3979
UST NEW INSTALL
JOB DESCRIPTION:
DESCRIPTION
DATE
SIGNATURE
BACKFILL
PRIMARY PIPE
SECONDARY PIPE
SECONDARY CONTAINMENT
SENSORS
AUTHORIZATION FOR FUEL
ELECTRICAL SEAK -OFF
TANK TESTING
UST REMOVAL
DESCRIPTION DATE SIGNATURE
EVR UPGRADE
MISC. ACTIVITY
REMARKS:
AST NEW INSTALL
DESCRIPTION DATE SIGNATURE
F- _-MODIFICATIONS MINOR / MAJOR
AST REMOVAL
DESCRIPTION DATE SIGNATURE
PRIOR-7-0 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: J161Z ;7_770
JOB DESCRIPTION:
OCCUPANCY TYPE:
OWNER: `�
PERMIT NO. 16nn Q�� 7
CONTRACTOR: � PHONE # 2Z- -•0668
FD 1743