Laserfiche WebLink
• SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES-ENVIRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE TANK PROGRAM FEE WORKSHEET <br /> FACILITY NAME FACILITY CONTACT NAME <br /> r24 <br /> enthal Trust Former JC Penny' s mr Rick Correia Bank of Stockto <br /> FACILITY ADDRESS SITE PHONE#WITH AREA CODE <br /> South American Street _CITY STATE ZIP CODE #OF TANKS AT SITE <br /> ockton CA 95204 ne (one) <br /> eenth <br /> PLICANT BILLING NAME APPLICANT CONTACT NAME <br /> _ Mr. Rick Correia <br /> ICANT MAILING ADDRESS APPLICANT PHONE#WITH AREA CODE <br /> 209 948-0434 <br /> STATE ZIP CODE LE WORK TO BE DONE: <br /> Stockton CA 95201 Closure stallation Repair Retrofit <br /> ACTIVE FACILITY UW*-0g,3;QE; <br /> 1996- 1999 2000 2001 <br /> $500 FEE INCLUDES FACILITY FEE+ 1 TANK ($170)X(#tanks)X(#of years applicable) <br /> $125 PER TANK AFTER FIRST TANK 1761176 <br /> 770 / f1 1170 1-70 170 LEW <br /> TANK PENALTY ASSESSED $ 8 p - <br /> TANK SURCHARGE=$8/TANK $ 10 <br /> ai <br /> STATE SURCHARGE FOR FACILITIES NOT ALREADY ON INVENTORY IN A CUPA PROGRAM=$10!FACILITY <br /> PERMANENT CLOSURE <br /> Removal or Permitted Closure in Place <br /> TANK ID# s : 1/TA261 <br /> CLOSURE FEE=$26NK #TANKS X$261 = <br /> $ <br /> TEMPORARY CL SU E <br /> (Plan Review and Inspections) $ <br /> TANK ID#(s): TEMPORARY CLOSURE FEE=$261 /FACILITY <br /> CHECK <br /> INSTALLATION PLAN <br /> Plan Check and Construction Inspections) $ <br /> TANK ID#(s): PLAN CHECK FEE_$696/FACILITY <br /> REPAIR PLAN CHECK <br /> TANK ID#(s): $ <br /> TANK LINING REPAIR FEE =$261 /TANK #TANKS X$261 = <br /> $ <br /> TANK RETROFIT REPAIR FEE =$261 /FACILITY $ <br /> PIPING REPAIR FEE =$261 /FACILITY <br /> MISCELLANEOUS <br /> TRANSFER FEE = $20 $ <br /> CONSULTATION FEE _ $87/HOUR $ <br /> UNAUTHORIZED RELEASE EVALUATION FEE = $67/HOUR $ <br /> SAMPLING INSPECTION FEE _ $87/HOUR <br /> ALL FEES ARE BASED ON THE$87 HOURLY RATE. TIME THAT E%CEEDS FEES PAID WILL BE 81LL PLIC <br /> OFFICE USE ONLYOU CI K <br /> SERVICE REQUEST# FACILITY ID AMOUNT RECEIVED CHECK# RECEIVED BY DATE RECEIVED <br /> SR ooa� d "F 1x746 <br /> EH 23 032(REVISED 2-6-01) <br />