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SAN JOAcUIN COUNTY Pl1BLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> b,.,AGROUHO STORAGE TANK PROGRAM • FEE WMKSHEE' <br /> FARamacher <br /> TY SITE NAME FACILITY CONTACT NAME <br /> ManufacturingKen Ramacher <br /> SITE PHONE I with AREA CODE <br /> TY ADDRESS <br /> L 5023 N. Flood Rd. 20 31-26 <br /> STATE ZIP CODE I of TANKS <br /> Y CITY Linden, Ca. 95236 et SITE 3 <br /> A APPLICANT/BILLING NAME APPLICANT CONTACT NAME <br /> ° Ken Ramacher <br /> ° Ramacher Manufacturing <br /> t APPLICANT PHONE N WITH AREA C E <br /> I MAILING ADDRESS <br /> C P.O. Bx. 506. ��Y^4 <br /> A STATE ZIP CODE E of APPLICATION <br /> N CITY CL URE, INSTALLATION, etc. Removal <br /> I Linden, ca. 9523 <br /> TOTAL <br /> ATS <br /> : 1987 1988 1989 1990 <br /> C CCc11 <br /> I ARRUAL FACILITY FEE (Prior to J&MI 1, 1991) 5100.00 <br /> I C <br /> V <br /> E TANK FEE 150.00/LANK (prior to January 1,1991) f a ter January 1, 1991) <br /> F I Tanks 1906 1987 1988 1989 1990 1 1992 1993 1994 1995 1996 <br /> A fail tlplY 1r by fee for — <br /> •+rh y+r argl it ahl e) <br /> L STATE SURCHARGE = 556.00 each TANK (Due every 5 years) see California H E 9 Code, Section 25287 <br /> I R Tanks m 156.00 1986 through 1990 <br /> 1991 through 1996 <br /> r (enter amolnt and year) f <br /> PERMANENT CLOSURE (Removal or Authorized tl osure-in-Pl ace) LANK I.D. I(s) +'�"'(c�/ —' —•�' —� 1)0 <br /> C477.00 <br /> I. CLOSURE IEE 153.00 per hour (3 hours min loam per TANK) I TANK(s)— % !159.00 IS <br /> 477-00 <br /> S <br /> U TEMPORARY CLOSURE (A one-time permit, for review/Inspect lam) TANK I.D. I(s) <br /> R <br /> E TEMPORARY CLOSURE FEE 1150.00 each TANK I TANK(s) % f150.00 = f <br /> ---------------- <br /> P PLAN CHECK (Install. Plan Review t Construction Inspections) TANK WFAD. <br /> L <br /> A 1 <br /> N rPLAM CHECK FEE - 153.00 per hour (8 hours minimus per Facility) = $424.00 mini mus <br /> R REPAIR FEE (workplan review 1 construction Inspections) TANK I.D. 8(s) <br /> — <br /> E <br /> P TANK REPAIR FEE = $53.00 per hour (3 hours minin"WTANK) I TANK(s) — % $159.00 = 1 <br /> A <br /> I 1 <br /> R PIPING REPAIR FEE = 553.00 per hour 0 hour minimum per facility • $159.00) <br /> M CCHSULTAITORS UNAUTHORIZED RELEASE EVALUATION SAMPLING INSPECTION <br /> 1 <br /> S <br /> C FEE = 553.00/hr FEE = 153.00/hr FEE = f 53.00/hr <br /> TOTAL DUE 1 477 <br /> OrFICE USE ONLY _ _ ........... ....................... ............... .........................................._........_........... ._.............................._...._..._._ <br /> iMY1M•,w•MM Na,Nw�MeeM�YMMrwp..wMIW I,.WpM�wr l�,MaMa�wrt�=tMr NOW's aM��awrf,W�1�,1s r�Y�M 1�,NA�M+,wMww <br /> Off <br /> M M• MwVm'VItR 1r L01: lWe 11'51 lUlt N1lA1NCw lN3LIC(Ir/t,ASN NFplt.Le�lnytw ar ~ V^^A/N,—Ey/RtI.E_IV[+_w� �� • <br /> (IF qc viw'w iwi w'r iw a,w w"I rO�www•ii wiw iw" _•iww•a iijj <br /> w iiww ria.Sw wwiiw�+a •�w ru'�w <br /> ww wow wM waw MM My a„eiwiiaww wawMw ww <br /> MMM/M MMWtM MMM MAMMMM MMMMMMMM MMM M/MM MIIIWMMMM AM AMMM AIIWMMM MAW MarMMM MAIM MMM MM MMM A�a.rrIAN AMRAMM <br /> IN 23 032 (REV 1/10/911 1t Page 1 1 (/-.///// ✓//// <br />