HomeMy WebLinkAboutGas/Liquid Fuel Tank Permit HA WAIL FIRE DEPARTMENT Dltz
FIRE PREVENTION B UREA U PaSaneN Amount$2(XW
HILO:25Aiipimi St.Suite 2501,Hilo,FII9h'20 (80S 932-2912 Re¢ai,,ABS
DUS.4: - -50 Ane Keohokalole HZ�1,Bldg E.Kaihia-Kona,HI 9h' 0(808)323- -60 Permit Nmnbei
TANK INSTALLATION PERMIT APPLIC'ATIO
Completed application shall be submitted with payment to the Hilo or Kona fire prevention office. Payment may be
cash or check. Checks shall be made out to `County Director of Finance'.
(To be completed bh applicant)
Permit Type: ❑LPG(>125 gal) Flammable or Combustible Liquid Storage Tank(>60 gal)
❑ Aboveground Storage Tank(AST)
❑Underground Storage Tank(UST)
Tank Capacity: Tank Construction:
Fuel Type: Front Back Sides
Distance from nearest building: Distance from property line:
Tank Owner:
Tank Location/Address: TMK:
Citv/State: Zip Code:
Installer/Contractor: License#
Applicant: Phone:
Fax: E-Mail Address:
Mailing Address for Permit:
*A Site Map shall be attached and submitted with this application. Site map shall depict all structures and tanks,and its
distances to buildings, other tanks, and property lines if applicable. Site map shall also show the location of vehicular
protection,and location of all fire extinguishers.
(To be completed by HFD)
INSPECTION
Detailed site map submitted ❑Yes ❑No Vehicle protection satisfactory ❑Yes ❑No ❑N/A
Distance between tanks satisfactory(table 66.2.3.2.2.1 or table 69.3.3A (2006 NFPA 1)) ❑Yes ❑No ❑N/A
Distance to property line satisfactory(table 66.2.3.2.1,* or table 69.3.3.1 (2006 NFPA 1)) ❑ Yes ❑ No
Distance from building openings/exposures satisfactory(table 69.3.3.9 and table 69.3.5.3) ❑Yes ❑No
Fire protection systems(check all that apply): ❑Sprinkler ❑Foam ❑Fire Alarm ❑ Other [_]N/A
All fire systems satisfactory [-]Yes ❑No ❑N/A
Portable fire extinguishers satisfactory [-]Yes ❑No ❑N/A
Date portable fire extinguishers inspected: Inspected by:
Comments:
APPLICANT SIGNATURE: DATE:
INSPECTOR SIGNATURE: DATE:
Revised 4/13/2012