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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.Si9ov.ore/ehd FACILITY NAME PERMANENT CLOSURE Removal or Permitted Closure in Place) TANK ID # (s): CLOSURE FEE = $315 / TANK # TANKS X $315 = $ TEMPORARY CLOSURE Plan Review and Inspections) TANK ID # (s) : TEMPORARY CLOSURE FEE _ $315 / FACILITY $ INSTALLATION PLAN CHECK Plan Check and Construction Inspections) TANK ID # (s) : PLAN CHECK FEE = $840 / FACILITY $ REPAIR PLAN CHECK TANK ID # (s) : TANK RETROFIT REPAIR FEE = $315 / FACILITY (use For monitoring equipment, Cold Starts, EVR upgrades, $ s ill buckets, sum s, misc. 375 PIPING REPAIR FEE = $315 / FACILITY use for piping, under -dispenser containment, ect. $ MISCELLANEOUS TRANSFER FEE _ $ 20 $ CONSULTATION FEE _ $ 105/ HOUR $ UNAUTHORIZED RELEASE EVALUATION FEE = $ 105 / HOUR $ SAMPLING INSPECTION FEE = $ 105/ HOUR $ ALL FEES ARE BASED ON THE 3105 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT. OFFICE USE ONLY ESERVICE REQUEST# FACILITY ID AMOUNT RECEIVED CHECK N RECENED BY DATE RECEIVED SR EH 23 032 (REVISED 02/23109) . v1\ I^�' I Nowt Chevron manager FACILITY ADDRESS SITE PHONE It WITH AREA CODE 10858 Trinity Parkway, Stockton CA 95219 209-9 2-2213 CITY STATE ZIP CODE # OF TANKS AT SITE Stockton CA 95219 3 APPLICANT BILLING NAME APPLICANT CONTACT NAME Able Maintenance, Inc Marty Weithman APPLICANT MAILING ADDRESS APPLICANT PHONE # WITH AREA CODE 680 Quinn Ave. 408 213-6038 CITY STATE ZIP CODE CIRCLE WORK TO BE DONE ACTOR ICC # San Jose CA 95112 � � E5252033 ACTIVE FACILITY $500 FEE INCLUDES FACILITY FEE + 1 TANK (2003-2008) 2004 2005 2006 2007 2008 2009 $550 FEE INCLUDES FACILITY FEE + 1 TANK (2009) $ $125 PER TANK AFTER FIRST TANK TANK PENALTY ASSESSED $ TANK SURCHARGE = $15 /TANK $ STATE SURCHARGE FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM =$24.00/ FACILITY $ PERMANENT CLOSURE Removal or Permitted Closure in Place) TANK ID # (s): CLOSURE FEE = $315 / TANK # TANKS X $315 = $ TEMPORARY CLOSURE Plan Review and Inspections) TANK ID # (s) : TEMPORARY CLOSURE FEE _ $315 / FACILITY $ INSTALLATION PLAN CHECK Plan Check and Construction Inspections) TANK ID # (s) : PLAN CHECK FEE = $840 / FACILITY $ REPAIR PLAN CHECK TANK ID # (s) : TANK RETROFIT REPAIR FEE = $315 / FACILITY (use For monitoring equipment, Cold Starts, EVR upgrades, $ s ill buckets, sum s, misc. 375 PIPING REPAIR FEE = $315 / FACILITY use for piping, under -dispenser containment, ect. $ MISCELLANEOUS TRANSFER FEE _ $ 20 $ CONSULTATION FEE _ $ 105/ HOUR $ UNAUTHORIZED RELEASE EVALUATION FEE = $ 105 / HOUR $ SAMPLING INSPECTION FEE = $ 105/ HOUR $ ALL FEES ARE BASED ON THE 3105 HOURLY RATE. TIME THAT EXCEEDS FEES PAID WILL BE BILLED TO APPLICANT. OFFICE USE ONLY ESERVICE REQUEST# FACILITY ID AMOUNT RECEIVED CHECK N RECENED BY DATE RECEIVED SR EH 23 032 (REVISED 02/23109)