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Home My WebLink About4901 LISA MARIE_UST MINOR MOD 3.10.10HOODS ALARMS SPRINKLER: SYSTEMS SPRAY BOOTH Permit No. Permit No. 21 1E File Number, 4. 10d 3 7— 3f DOW Rd-;61vdd:__3__Z� New Mod. 13 0 Q : System Commercial Hold'S' t 0 0 Ffire'WAr"th-tSy M 0 0 Fire Sprinkler System 11 0 a r-8 Fin- o v'stem p -V 0 0 Ab o*v'e- ground Storage Tank ❑ Unde'Fg round Storage Tank modification Urfdergr6lUnd Storage Tank removal Underground Storage Tank O Other: Permit No. Address: Permit No. Business Name: I y Cr IILDING BUT.1.1dih-0 Stlw.; -Fdttp. Call'bulaltioh S1, Ft: AST Permit No. 2. 4* UST Permit No. 6-1666601 Miwa;lwm� � 'Aw '$igna 'tu r e Comments: 22 1E �. \ 4e � `� �' M UNDERGROUND STORAGE TANKS ftpi BAKERSFIELD FIRE DEPT. B B D PIRR Prevention Services ARr11I r 1501 Truxtun Ave., First Floor APPLICATION` Bakersfield, CA 93301 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 Page 1 of 1 PERMIT NO. i ❑ ENHANCED LEAK DETECTION LINE TESTING ❑ SB -989 SECONDARY CONTAINMENT TESTING ❑ TANK TIGHTNESS TEST D TO PERFORM FUEL MONITORING CERTIFICATION ..... .''�I.' SITEr.INFORMA (ION.... FACILITY, NA Z& & PHONE UM ,ER OF CONTACT PERSON �C X22 lr� - -7 ooz te ADDRESS 4q O 1 "e tX ` ( `lam 0PE ATO S N E 1 1 PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED I PIPING GOING TO BE TESTED? ❑ YES ❑ NO TANK# VOLUME CONTENTS NAME OF TESTING COMPANY Tanknolo Inc. NAME & PHONE NUMBER OF Wesley Coulter 800- 666 -2176 gy, CONTACT PERSON ext.12 MAILING.ADDRESS 41785 Enterprise Circle S. Suite D Temecula, CA 92590 NAME & PHONE NUMBER OF CERTIFICATION #: �`•n TESTER OR SPECIAL INSPECTOR: 1, 72 Ci Ss DATE & TIME TEST TO, E * ICC #: i i Lo- TEST L-ID1 CONDUCTED: ', o t I (C METHOD SIGNATURE OF APPLICANT DATE: APPROVED BY DATE FD 2095 (Rev. 09/05) °AXE® MAR 0.2010 OIDpm V COO.DO'OL. 0.0 0 0 Company Name: Tanknology Technician Name: Start: End: (Date/Time) 7 (Date /Time) Work Performed: ' PARTS: Qty, brand, model, serial #, cost Additional Tech Name(s): Start: End: (Date/Time) (Date/Time) Work Performed: 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 PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF DESCRIPTION DATE SIGNATURE 1 DESCRIPTION I DATE I SIGNATURE 1 ---MODIFICATIONS MINOR/ MAJOR SIGNATURE PRLOR 1000PER_ATION- OF-ANY SYSTEM, ALL UST`A_ND /ORAST-SYSTEMS SHALL BE INSTALLED, COMPLETE AND ACCEPTED BY THEBAKERSFIELD CITY'FIRE DEPARTMENT. FIRE DEPARTMENT (FINALI I I I 13UILDING ADDRESS <Z6 A77747 77 c :7 JOB DESCRIPTION OCCUPANCY TYPE OWNER c_ V16 Z'Z PERMIT NO. CONTRACTOR —4.3 Ne .PHONE S06 )66 a/ FD 1743 TANKNOLOGY TESTING NOTIFICATION Southern California Regional Office Tanknology Corporate Headquarters 41 785 Enterprise Circle South, Suite D 8501 North MoPac Expressway, Suite 400 Temecula, CA 92590 Austin, TX 78759 n 951 - 676 -4060 512- 451 -6334 = 800 - 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(cD-tanknology.com - DATE: 3/10/2010 TIME: NO. OF PAGES INCLUDING COVER: 1 ORIGINAL TO FOLLOW: No COMMENTS.- Tanknology will be at the following locations: Tankno logy, 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. o � e 0 0 e o a 0 APCD SAN DIEGO AIR POLLUTION CONTROL DISTRICT APCD USE ONLY COMPLIANCE DIVISION SECTOR 10124 OLD GROVE ROAD !�i PIlL1TI1N gNT1Hl N:iI�Ci SAN DIEGO CA 92131 -1649 ID# COUNTY 9 F SAN 01 E 8 11 PHONE (858) 586 -2650 FAX (858) 586 -2651 NOV# PRESSURE DECAY TEST ❑ 2" TP -201.3 ❑ 5" TP- 201.3A ❑ 10" TP 96 -1 ❑ Renewal Testing ❑ Compliance Witness ❑ Compliance Testing ❑ Engiaeering Evaluation (Contractor only) (District only) (District only) (District only) Facility Name: A/C oil PO Number: Time of Test: (Record exact time of test in order to demonstrate proper test sequencing as required in Attachment A) Phase I System & EO #: Date /Time of Most Recent Delivery: Phase 11 System & EO #: Date /Time of Most Recent A/L Test: No. of Nozzles Affected: Pressure Measuring Device Type: Vapor Manifold Location: Device Calibration Date: All four CAS Ball valves closed before conducting test' Yes ❑ . -No ❑ Yes E] No ❑ . All four CAS ball valves in normal operating positions after conducting test' Yes ❑ No ❑ All dispenser piping test valves open before conducting test � Tank Number: 1 2 3 4 Total Product Grade: Tank Capacity, gallons: Gasoline, gallons: Ullage, gallons: Initial Pressure2, wcg: Pressure @ minutes: Pressure @ minutes: Pressure @ minutes: Pressure @ minutes: Final pressureZ @ minutes: Allowable Final Pressure, wcg: Pressure Decay Test Results: ❑P/ ❑F ❑P/ ❑F . ❑P/ ❑F ❑P/ ❑F ❑P/ ❑F Tank Tie Test: P/ F P/ F P! MIT P/ MF P/ Fjf REV 04.07 'This is only applicable to facilities with Phase 11 Enhanced Vapor,Recovery Systems as specified in the ARB Executive Orders VR -201 -X and VR -202 -X (Note X refers to version of the ARB Executive Order) 2. Pressure measurements shall be recorded to the nearest hundredth of an inch we (.01" we). Any rounding must be done after calculating the overall pressure decay rate(e.g. the actual differential shall not be more than 0.14" we if the test procedure allows a differential of 0.1" we. Will Rogers External Certifications Cert # Date Completed Due Date Internal Certifications Date Completed Due Date OP1N, Tank Gau' °es'EECQ 1 "500 - „- „ ,- 902530 , .; ,, 8/30/2008,,;; 8730/201.1 ', Safe. 6!30/2009, ;- OR1N .. Phase I; EVR „ _.,..- _.. ; , 51,5'1. tr7,/28/2009 =” ;.,7/28%2011,,a 0 FTA, ... >..see „note 0, 66k ., ; „ Veeder,Root Red E, ; A298 „84 . £ _„2/26/2010:; 2;;2572015 - Veeder :Root Red, JacketzLD , . . 5429884,, , s; 1.2/30/2009 ;' ;12!29/2011. °° Uacutect , . ,,. , . ;' .._ 6%30/2009: " , 6/30/201,1 Veeder Root Level 2 -3 /2D 01.1;=0;. Veeder, Root,level;;4 11 Stage fl Veeder Root ISD ; AT6, - 6/30/2009 ;' a ,fi43042011` Veeder, Root ,.ISD'w /PMC ;CCVP- °- ,..;:; Tp.1 -,: ;- - - -- 6/3,0/2011. VST EVR Seeonda "' Cont`:. 1/22/2010 ; 1721/2013'` 035 : ,. , ., 6220 ..- ./A WT , ._, _. 6/30/2009 SCAQMD - 461 Gonfined;S aces San Joaquin GDF 8166113701, >, ;, '2 12/4 201.1 104954 °3761. ' 4/14'72009, „- 4/14/2011 Wei 'hts, &:Measure, 0- 2083 ,4/24/2009 r; ; 4724/2014 GNIa °.,... ...,1.41'5 x e.... ''::7/23/2009 ��7I23/2011° Beaudreau a -site Beaudreaus40.0::500 SI =317 ;, ....; 4/28/2006 Incon ,FMS level ;,1` Installation _; 1,049543761 ; . °4" "/24/2008 I,ncon FMS,Iev „el''2.Pro r'ammin r.- ;1049543761. `, 4/24/2008. Incon ;FMS level3 Leak<tletection $16611'3701;. Y :2/9720,110 2/9/2012 ICC - Vapor Recovery Installer ICC - Vapor Recovery Test & Repair �CC.<tJ3. tank' ti” htness`- testing . - -,. „ : . , . .. . , 03 4/2525;96 U 4/23/2h11_ APL' ;; , ' . 34088915,, ,' g~ 1,2/23/2009 -.:; Blue! -me CA= ;1:157 812008,_ -' = &118/2011, Ckwf ... 7/31/2009 #3`1;642 A i - VMf;Va oE{essaanknolog' -., ,- .F 2042.- 1'/30/2009,,:; „1%3012011 ,= Vr swd 10'rrintec. 073007WR ."2/91201.0. 2/9/2012`. _ FF o e ®X yp�99 0'0 0 0 o SAN DIEGO AIR POLLUTION CONTROL DISTRICT APCD USE ONLY APCD COMPLIANCE DIVISION SECTOR 10124 OLD GROVE ROAD M1 Pau SAN DIEGO CA 92131 -1649 1D# c a u N r 7 Of BAN o t E S o PHONE (858) 586 -2650 FAX (858) 586 -2651 NOV # PRESSURE DECAY TEST ❑ 2" TP -201.3 ❑ 5" TP- 201.3A El 10" TP 96 -1 F-1 Renewal Testing F1 Compliance Witness ❑ Compliance Testing ❑ Engiaeering Evaluation (Contractor only) (District only) (District only) (District only) Facility Name: A/C or PO Number: Time of Test: (Record exact time of test in order to demonstrate proper test sequencing as required in Attachment A) Phase I System & EO #: Date /Time of Most Recent Delivery: Phase 11 System & EO #: Date /Time of Most Recent A/L Test: No. of Nozzles Affected: Pressure Measuring Device Type: Va por Manifold Location: Device Calibration Date: All four CAS Ball valves closed before conducting testa Yes ❑ No ❑ Yes ❑ No E] All four CAS ball valves in normal operating positions after conducting tests Yes ❑ No ❑ All dispenser piping test valves opera before conducting test Tank Number: 1 2 3 4 Total Product Grade: Tank Capacity, gallons: Gasoline, gallons: Ullage, gallons: Initial Pressure2, wcg: Pressure @ minutes: Pressure @ minutes: Pressure @ minutes: Pressure @ minutes: Final pressure @ minutes: Allowable Final Pressure, wcg: Pressure Decay Test Results: ❑P/ ❑F ❑P/ ❑F ❑P/ ❑F ❑P/ ❑F ❑P/ ❑F Tank Tie Test: P/ RF P/ MIT P/ F P/ nF P! FIF REV 04.07 'This is only applicable to facilities with Phase 11 Enhanced Vappr Recovery.Systems as specified in the ARB Executive Orders VR -201 -X and VR -202 -X (Note X refers to version of the ARB Executive Order) 2. Pressure measurements stall be recorded to the nearest hundredth of an inch we (.01" we). Any rounding must be done after calculating the overall pressure decay rate(e.g. the actual differential shall not be more than 0.14" we if the test procedure allows a differential of 0.1" we. TRANSMISSION VERIFICATION REPORT TIME 03/10/2010 13:30 NAME TANKNOLOGV FAX 9516764061 TEL 9516764060 SER.# 000B7J224433 DATE DIME 03/10 13:29 FAX N0.' /NAME 916618522171 DURATION 00:01:32 PAGE(S) 03 RESULT OK MODE STANDARD ECM i Desert% ti; N C EP r- Ten&e A,4e CV CHEF Tatai-,ten Total, pay Trans dat t :f CONSTRUCTION PERMIT BAKERSFIELD FIRE DEPARTMENT PREVENTION SERVICES s S R S P I D 1501 TRUXTUN AVENUE, 1sT FLR FIRE BAKERSFIELD, CA 93313 &R � T Office Phone: (661) 326 -3979 Application Number . . . . Property Address . . . . . ATN (11 Digits): Application type description Subdivision Name . . . . . Property Use . . . . . . . Application valuation . . . Owner USF REDDAWAY INC 10990 ROE AV OVERLAND PARK KS 66211 10- 10000082 Date. 3/12/10 4901 LISA MARIE CT 499 - 080- 07 -00 -1 FIRE DEPT 0 Contractor OWNER ---------------------------------------------------------------------------- Permit . . . MANDATED LEAK DETECT TEST Additional desc . Phone Access Code 984989 Permit Fee 96.00 Plan Check Fee 96.00 Issue Date 3/12/10 Valuation . . . . 0 Expiration Date 9/08/10 ---------------------------------------------------------------------------- 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 after180 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 CjPhoneNo. 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 x > ,.; 174& �*7, x ° �- ,: ._ 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 constniction and hereby authorize representatives of the city to enter the above mentioned- property for inspection purposes. Signature of Applicant or Agent _ x -= _ _�_ , _ Date