Laserfiche WebLink
SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> KR6ROUND STORAGE TANK PROGRAM - FEE WORKSH <br /> FFACILITY/SITE NAME FACILITY CONTACT NAME <br /> A <br /> C KBTS Luther Russell <br /> 1 <br /> L STREET ADDRESS 23675S. Airport Way, SITE PHONE 1 (with Area Code) <br /> 1 (209) 823-3897 <br /> T <br /> Y CITY Manteca STATE IIP CODE 1 of TANK'S <br /> CA at Site 1 <br /> A APPLICANT/BILLING NAME APPLICANT CONTACT NAME <br /> P KBTS <br /> P Luther Russell <br /> L <br /> I MAILING ADDRESS 13515 Marengo Road APPLICANT PHONE 1 (with Area Code) <br /> A (209 823-3896 <br /> N CITY Galt, STf�T IIP CODE TYPE of APPLICATION <br /> T t 95632 (Closure, Installation, et(.) Removal <br /> FACILITY FEE _ $100.00 each SITE ADDRESS per YEAR TOTAL <br /> A <br /> C 1986 1987 1988 1989 <br /> T <br /> I $ <br /> V <br /> E TANK FEE _ $50.00 each TANK <br /> F 1 Tanksr $50.00 1986 1987 1988 1909 <br /> A (multiply_1_by fee for <br /> C each year applicable) $ <br /> I <br /> L STATE SURCHARGE _ $56.00 each TANK (see CA HEALTH 1 SAFETY CODE Sec 25287 for applicability) <br /> I <br /> T 1 Tanks x $56.00 1986 1987 1988 1989 <br /> Y (enter ii5iik and year) <br /> f <br /> C PERMANENT CLOSURE (Removal or Closure-in-place) <br /> L <br /> 0 CLOSURE FEE _ $90.00 each TANK 1 Tanks ] x $90.00 $ 90.00 <br /> 6 <br /> U <br /> R TEMPORARY CLOSURE (Only allowed one time for up to two years) <br /> E <br /> 1EMPORARY CLOSURE FEE _ $80.00 each TANK 1 Tanks x $80.00 $ <br /> P PLAN CHECK (Installation or Repair) <br /> L <br /> A <br /> N PLAN CHECK FEE _ $30.00 each SUBMISSION/RESUBMISSION $ <br /> REPAIR <br /> R <br /> E TANK REPAIR FEE _ $110.00 each TANK t Tanks x $110.00 $ <br /> A <br /> 1 PIPING REPAIR/CLOSURE/REMOVAL (Fees are per hour, minimum one hour to be paid on plan submittal) <br /> R <br /> UNAUTHORI2EQ RELEASE EVALUATION CONSiRUCT10N SAMPLING <br /> (when applicable) INSPECTION INSPECTION <br /> FEE = 130.00/hr FEE _ $35.00/hr FEE -- 135.00/hr $ <br /> TOTAL DUE $ yU. G0 <br /> OFFICE ISE ONIK <br /> SWEEPS 1 COMP t LOC CODE D[ST CODE AMOUNT DUE AMOUNT RCVD CHECK /CASH RCVD BY QATE RECEIVED PERMIT <br /> sS <br /> d <br />