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RI C T <br /> £3-I a 7 fix Y 7 <br /> q. X40 11" <br /> AN J 0 Lli <br /> PR4CRA►f fEE.1139°K5r(Ft <br /> �' -- — <br /> T.'f ACI1ITYlSiTE NAEz — f, ' t ii IL1lY CONTACT NAME.' .A <br /> A' x Doane €'roducts Company. R��bert Faqurides <br /> ., i71 <br /> ., - ;xMr,'�. ,-.. <br /> L 'STP.IET AtlERE55 --- - " PHONE 1 with Area Code,, , 45 <br /> r 1 , 450 E. G� ,ant� ne Road,. <br /> (209) €335 0133 <br /> r Y C-ITY '— µ -- --¢ 5'TATE�I IP CODE 1. of TANY'S - <br /> ` A $ Tracy. « CA 9376' at Site 3 <br /> a — --- — - 1_ <br /> #sr A .APPII ANTlSILiiN6 NAME a APPLICANT CONTACTI+E <br /> NA - <br /> �! MAILING ADD''l SS APPLICANT PHONE 1,(with Area Code) ,• �: <br /> NICITY ? . STATE ZIP CODE . -TYPE 4i( APPLICATION . 'Tank removals <br /> IClosure, installation, .Ptr }. ' <br /> .OQ each�SlTF. AP+P ESS per..YEAR - � $ TOTAL <br /> € <br /> ACILIT, FEE ii00 X — <br /> C a LSA !'?8] .. l9B$ '1983 •: <br /> E TAH}: FEE <br /> 450.00 each TANY; <br /> { k 1 Tanks r i;SQ.Q�! 1985 - 1987 1 <br /> A (lul t ip" '389 <br /> y 1 'ay fee ,nr -- <br /> r : year appl ica€';e) S'O <br /> _ <br /> wa <br /> F- E STATE S�iRCHARfzE = $56.00 eat n TANS; isce CA HEAL IH SAFETY CODE Sec, 2520 f or app,l ic ahj I i ty 1 f,!. <br /> „ # Tans x 456.QC .` 1iB5 1981 1988: —1389 �r <br /> w <br /> Y feeler aaount and year; <br /> r PEFaANER, LC'S"JRE (Re;5"al ur Closure in place)_ <br /> U.r,LOSOPF FEE W'x]b,t)c� each t.4NK, C 'f <br /> �U 7:74. <br /> — _ _ ---- <br /> F, TEMP CL03UF� tOr�Iy allove4 une 'sunt ftir up,l- tv,, vears) <br /> TE?lPDRARI CLOSURE FE" >184.�}0 pa(h TANK 1 Tanks ` x igo.Qf3 5F <br /> z <br /> P,60 (:NECK tlnstallation or Repair) <br /> ![!LAN CHECK FEE - 1;.,0,06 each SUBMISSION.RESUPM,SSION t' a <br /> E TANK REPAIR F££ = i1;4.6Q each IAtI' 4i 1 Tar,ks . x i11Q i�Q <br /> tet <br /> ` I PIPING rREPAlR/CLGSURElP,EMOVAL (fees are per hour,-iiiniauo one hour •!o lie paid on plan subaittal+_ _UNAUTHORIZED RELEASE EVALUATION CONSTRUCTION <br /> SAMPLING "" f <br /> iuhen epplicahlEl �IN5FECTiDN tH5PECTiO4 <br /> 1_4.Whr�' l EE - 435.001hr. w EfE i35 <br /> TAL <br /> ¢' OFFICE USE QRLY <br /> { 9EEPS 1 Ct9"FP,f LOC CODE DIST CODE AMOUNT DUE 'AMOUNT CVD HECK, CASH RCVD BY' DATE;RECEIVEii PERMIT 1 s <br /> f fp 4 <br /> '6 %. •P x -iy,, it ,a '3'{' �'4 t i t .. � � 7s-�.r.x <br />