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SAN JOAQUIN COIJNT'*FUBLIC HEALTH SERVICES - ENVIRONMENTAL HEALVIVSION <br />UNDERGROUND STORAGE TANK PROGRAM - FEE WORKSHEET <br />�S <br />FACILITY SITE NAME <br />TANK I.D. <br />X(s) <br />FACILITY CONTACT NAME <br />I <br />CAPITOL AUTO <br />SALES <br />11988 11989 <br />JAGENDER SINGH <br />r <br />TEMPORARY CLOSURE (Plan Review a Inspections) <br />TANK I.D. <br />ANNUAL FACILITY FEE (Prior to January 1, 1991) = $100.00 <br />'E <br />A6 <br />FAC dTYEADD MINER <br />AVENUE <br />{ S <br />SITE PRONE X with AREA CODE <br />C209) 466 <br />%XXX <br />%%XX <br />9082 <br />a <br />XXXX <br />S XXXXX%xX <br />A <br />A <br />N <br />C <br />cITTOCKTON <br />mini mm <br />S <br />STATE <br />ZIP CODE <br />X of TANKS <br />A <br />P <br />R <br />E <br />REPAIR FEE (workplan Review a Construction Inspections) <br />CA <br />95202 <br />at SITE ONE , KNOWN <br />P <br />A <br />TANK LINING REPAIR FEE = 578.00/hour (3 hours minimm/TANK) <br />X TANK(s) <br />X 5234.00 = <br />f <br />P <br />APPLICANT/BILLING NAME <br />= 5234.00 <br />minimum <br />APPLICANT CONTACT NAME <br />L <br />I <br />JAGENDER SINGH <br />- 5734.00 <br />JAGENDER SINGH <br />S <br />%X%% <br />XXXX <br />%XXX <br />X%XX <br />C <br />MAILING ADDRESS <br />1 <br />APPLICANT PHONE X WITH AREA CODE <br />A <br />N <br />650 E. MINER <br />AVENUE STOCKTON <br />CA 95202 <br />TI <br />CITY <br />STATE ZIP CODE TYPE of APPLICATION CLOSURE <br />STOCKTON <br />CA 95202 (Closure, Installation, etc.) <br />TOTAL <br />CPERMANENT <br />Ll <br />CLOSURE (Removal or Authorized Closure -in -Place) I <br />TANK I.D. <br />X(s) <br />01 <br />S. <br />1986 <br />1987 <br />11988 11989 <br />S <br />934 On <br />1990 <br />TEMPORARY CLOSURE (Plan Review a Inspections) <br />TANK I.D. <br />ANNUAL FACILITY FEE (Prior to January 1, 1991) = $100.00 <br />E <br />TEMPORARY CLOSURE FEE = S78.00/hour (3 hours mirimum/FACILITY) <br />S234.00 minimum <br />{ S <br />%XXX <br />%%XX <br />j %XXX I <br />%XXX <br />XXXX <br />S XXXXX%xX <br />A <br />A <br />N <br />C <br />= S624.00 <br />mini mm <br />S <br />R <br />E <br />REPAIR FEE (workplan Review a Construction Inspections) <br />TANK I.D. <br />X(s) <br />P <br />A <br />TANK LINING REPAIR FEE = 578.00/hour (3 hours minimm/TANK) <br />X TANK(s) <br />X 5234.00 = <br />f <br />I <br />R <br />TANK RETROFIT REPAIR FEE = 578.00/hour (3 hours min./FACILITY) <br />= 5234.00 <br />minimum <br />S <br />T <br />FACILITY PENALTY FEES ASSESSED (If Applicable) <br />- 5734.00 <br />_ <br />minimum <br />S <br />%X%% <br />XXXX <br />%XXX <br />X%XX <br />%%%X <br />f %%%XXXX% <br />1 <br />V <br />TANK FEE = 550.00/TANK <br />(Prior to January 1,1991) <br />5170/TANK <br />(After <br />January <br />1, <br />1991) <br />E <br />X Tanks = <br />1988 1989 <br />1990 <br />1991 <br />1992 <br />1993 <br />994 <br />F <br />1995 <br />11996 <br />1997 <br />1998 <br />F <br />(mulcipLy X by fee for <br />%%%X %X%X <br />%%XX <br />%%X%XXXX <br />5 <br />A <br />each year appticahle) <br />C <br />I <br />TANK PENALTY =E -e5 ASSESSED <br />I xXXX %XXX <br />XXXX <br />XXXX <br />(XXXX <br />I <br />I <br />I <br />S <br />L <br />I <br />STATE SURCHARGE FOR NEW FACILITIES ONLY*$18.50 <br />S <br />T <br />Y <br />X Tanks_ s 58.00 <br />1988 chrou9t <br />1993 <br />(556) <br />1993 through <br />1997 ;556) <br />1998 <br />SURCHARGE FOR 1998 <br />%XXX%X%%XXXXXXX)(XXXXXXX%XXX <br />XXXXX)01X%XXXXXXXXXX)(XxX <br />S <br />CPERMANENT <br />Ll <br />CLOSURE (Removal or Authorized Closure -in -Place) I <br />TANK I.D. <br />X(s) <br />01 <br />S. <br />CLOSURE FEE = S78.00/hour (3 hours minimm/TANG)I <br />X TANK(s)�E <br />X 5234.00 = <br />S <br />934 On <br />U <br />R <br />TEMPORARY CLOSURE (Plan Review a Inspections) <br />TANK I.D. <br />X(s) <br />E <br />TEMPORARY CLOSURE FEE = S78.00/hour (3 hours mirimum/FACILITY) <br />S234.00 minimum <br />{ S <br />P <br />L <br />INSTALLATION PLAN CHECK (Plan Review a Construction Inspections)I <br />TANK I.D. <br />X(s) - <br />A <br />N <br />PLAN CHECK FEE = S78.00/hour (8 hours minimmm/FACILITY) <br />= S624.00 <br />mini mm <br />S <br />R <br />E <br />REPAIR FEE (workplan Review a Construction Inspections) <br />TANK I.D. <br />X(s) <br />P <br />A <br />TANK LINING REPAIR FEE = 578.00/hour (3 hours minimm/TANK) <br />X TANK(s) <br />X 5234.00 = <br />f <br />I <br />R <br />TANK RETROFIT REPAIR FEE = 578.00/hour (3 hours min./FACILITY) <br />= 5234.00 <br />minimum <br />S <br />PIPING REPAIR FEE = 578.00/hour (3 hours minima.^.'FACILITY) <br />- 5734.00 <br />_ <br />minimum <br />S <br />MTRANSFER FEE = SZO.00 I I UNAUTHORIZED RELEASE EVALUATION - S78.00/hr <br />Si <br />C1 CONSULTATION FEE = S78.00/hr SAMPLING INSPECTION FEE = S78.00/hr <br />CODE I DIST CODE <br />cN 7i n12 (RFVISFD 1-12-98) <br />