Laserfiche WebLink
SAN JOAQUIN COL PUBLIC HEALTH SERVICES - ENVIRONMENTAL NEI OIVSIOM <br />varum ar - WF WORKSHEET - <br />- - <br />PERMANENT CLOSURE (Removal or AWLnoriteo Closure-in-Ptace) <br />FACILITY CONTACT NAME <br />SI FAC:LITY SITE NAME <br />1986 17987 <br />Ron Palmquist <br />I <br />I Gateway Project <br />1989 <br />11990 <br />T <br />TEMPORARY CLOSURE FEE • S78.00/hour (3 hours minima/FACILITY) <br />517E PHONE x with AREA CODE <br />E FACILITY ADDRESS Plock bgyndeg by Lafayette, El <br />Dora o, 209-937-8320 <br />Center and Sonora ree s <br />P <br />I <br />a <br />STATE <br />ZIP COOS x of TANKS <br />C'TY Stockton I <br />CA <br />95202 at SITE <br />A <br />I xXXXit <br />xxxx <br />P APP''-ICANT/BILLING NAME <br />I <br />APPLICANT CONTACT NAME John Crawford <br />Evans Brothers Inc. <br />FACILITY PENALTY FEES ASSESSED (If Applicable) <br />i XXXX I <br />L <br />XXX% j <br />XXX% <br />XXX% <br />1 <br />I <br />V <br />TANK FEE = 550.00/TANK <br />APPLICANT PHONE 3'W WITH AREA CODE 925-443-0225 <br />C MAILING ADDRESS 7589 National Drive <br />5170/TANK <br />(Atter <br />Jaraliry 1, <br />A <br />E <br />At Tanks = 11988 <br />N <br />Ti(:I'Y <br />STATE <br />ZIP CODE TYPE of APPLICATION <br />1993 11994 11995 <br />CA <br />94550 (Ctosure Installation, etc.) <br />Livermore <br />1998 <br />C <br />PERMANENT CLOSURE (Removal or AWLnoriteo Closure-in-Ptace) <br />TANK I.D. %(S) Unknown <br />L <br />0 <br />5 <br />1986 17987 <br />11988 <br />i <br />1989 <br />11990 <br />R <br />El <br />TEMPORARY CLOSURE FEE • S78.00/hour (3 hours minima/FACILITY) <br />ANNUAL FACILITY FEE (Prior to <br />January 1, 1991) • 5100.00 <br />P <br />I <br />XXX% <br />XXXX <br />S XXXXXXXX <br />A <br />$ <br />I xXXXit <br />xxxx <br />XXX% <br />I <br />= S234.00 minimm S <br />7 <br />FACILITY PENALTY FEES ASSESSED (If Applicable) <br />i XXXX I <br />xxxx <br />XXX% j <br />XXX% <br />XXX% <br />S XXXXXXX) <br />I <br />V <br />TANK FEE = 550.00/TANK <br />(Prior to January 1,1991) I <br />5170/TANK <br />(Atter <br />Jaraliry 1, <br />19911 <br />E <br />At Tanks = 11988 <br />1989 11990 1991 <br />1 1992 � <br />1993 11994 11995 <br />11996 <br />�, <br />1997 <br />1998 <br />F <br />(multiply # ny fee for <br />%XXX %XXX XXXX <br />(XXXX <br />I <br />I <br />S <br />A <br />each year applicable) <br />i XXXX <br />I <br />II <br />TANK PENALTY FEES ASSESSED <br />xxxx <br />XXXX X)(XX I XXXX <br />(XXXX <br />I <br />I <br />I <br />I S <br />L <br />1 <br />STATE SURCHARGE FOR NEW FACILITIES ONLY -S18.50 <br />i S <br />T <br />T <br />N Tanks_ x 58.00 <br />I 1988 through 1993 <br />(S56) <br />1993 through <br />1997 <br />(1156) <br />1998 <br />SURCHARGE FOR 1998 <br />xXXXXXxxx%xxxxxxxxxxX%XXXX% <br />XxxxxxXXXxxxxxxxxxxxx%X <br />I S <br />C <br />PERMANENT CLOSURE (Removal or AWLnoriteo Closure-in-Ptace) <br />TANK I.D. %(S) Unknown <br />L <br />0 <br />5 <br />C'.OSURE FEE = 578.00/hour (3 hours minimANTANK)B <br />TANK(S) 1 K $234.00 = l s 234.00 <br />UTEMPORAR7 <br />CLOSURE (Plan Rs�ier 3 InSpeCtionS) <br />TANK I.D. :(5) <br />R <br />El <br />TEMPORARY CLOSURE FEE • S78.00/hour (3 hours minima/FACILITY) <br />$234.00 minimum 1 S <br />A <br />P <br />INSTALLATION PLAN CHECK (Plan Reviev S Construction Inspections) I <br />TANK I.D. 9(S) <br />L <br />A <br />N <br />PLAN CHECK FEE = S78.00/hour (8 hours minimm/FACILITY) <br />= $624.00 minimum <br />$ <br />R <br />REPAIR FEE (Workplan Reviev L Construction Inspections) <br />TANK I.D. N(a) <br />E <br />P <br />TANK LINING REPAIR FEE - S78.00/hour (3 hours minima/TANK) <br />s TANK(s) X 5234-00 • S <br />A <br />I <br />TANK RETROFIT REPAIR FEE = S78.00/hour (3 hours min./FACILITY) <br />• S234.00 minimus S <br />R <br />PIPING REPAIR FEE = S78.00/hour (3 hours minimuNFACILITY) <br />= S234.00 minimm S <br />MI TRANSFER FEE = 520.00 <br />I, <br />CI CONSULTATION FEE - S78.00/hr <br />FOR OFFICE <br />SWEEPS s <br />IN n 13: (RFVTSFO +.-12-98) <br />UNAUTHORIZED RELEASE EVALUATION • S78.00/hr <br />SAMPLING INSPECTION FEE - 578.00/hr <br />LOC CODE j DIST <br />S <br />*/CASH <br />S <br />�1 <br />1S <br />TOTAL DUE I S <br />RECEIVED BY I DATE <br />