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IY L40 , rwi+� "..TANK PROGRAM - FEE WORKSHEET <br /> UNOERGRCUmn STORAGE <br /> —N FACILITY CONTACT N1 j �I <br /> rime, <br /> 1 `-YtT SITE PHONE C with AREA CC <br /> 2E�lTEi ZIP CODE I 6 of TANKS C'� ` <br /> ( at SITE <br /> APPLICANT CJNTALi NAME I /�u�� <br /> ' APPLICANT/ LLING NA rZEA <br /> t _APPLICANT PHONE _O��MAILING ADDRES TE v 9C7PPLICATIIlreInstaLLClcs-l-v— <br /> TOTAL <br /> " 1986 11987 11988 1989 11990 <br /> ANNUAL FACILITY FEE (Prior to January 1, <br /> 1991) S100.DO X)= )000( I )0= I , /oo S 10v <br /> A I XA�O( I )000( I xx701 I I (00 S IOD <br /> FACILITY PENALTY FEES ASSESSED Cif Applicable) 5170/TANK (After January 1, 1991) <br /> i TANK FEE - 550.00/TANK (priorr t986 'anuaryq�t.t991 11990 1991 11992 11993 11994 11995 11996 <br /> f Tanks = fee for X7000 I r <br /> A ch yeaar applicable) X700( I X7000 I i0 !%.0 ¢'JO I /70 /Ofl) 17v <br /> ;n <br /> ( TANK PENALTY FEES ASSESSED I )0000 170000 170000 I <br /> 1 STATE SURCHARGE = 556.00 each TANK (Due ry 5 years) See California H 5 S Code, sec:-tion 25287 <br /> 7 through 4998 lad <br /> 199 through 49% ZeoO I1�(7 <br /> (Enter amo�att and year) y�7 <br /> TANK S.D. f1(s) <br /> PERMANENT CLOSURE (Removal or Author zed Closure'7n"Place) w TANK(s)_ X 5234.00 = S <br /> L 578.00/hour C3 hours minimum/TANK) I <br /> OI CLOSURE FEE = _ TANK I.D. WCs) <br /> S S <br /> U TEMPORARY CLOSURE (Plan Review 5 Inspections) <br /> R <br /> E TEMPORARY CLOSURE FEE = 578.00/hour C3 hours minims/FAC3LITY) I 5234.00 minimum <br /> P INSTALLATION PUN CHECK (Plan Review i Construction inspec:ions)I TANK I.D. �(s) 5 <br /> L = 5624.00 minimum <br /> A <br /> Y PLAN CXECX FEE = 578.00/hour (8 hours minimun/FACILITY <br /> TANK I.D. als> <br /> R REPAIR FEE (Workplan Review i Construction Inspections) i % S234.00 = S <br /> C TANK(s) <br /> E <br /> TANK LINING REPAIR FEE - S78.00/hour (3 hours minimAxm/TANK) I S <br /> A = 5234.00 minimum <br /> I TANK RETROFIT REPAIR FEE = S78.D0/hour (3 hours m7^•/FACILITY) I S <br /> R5234.00 mininxm <br /> PIPING REPAIR FEE = S78.00/hour (3 hours minimuo/FACILM) <br /> N TRANSFER FEE = 520.00 I UNAUTHORIZED RELEASE EVALUATION = 578.00/hr <br /> 578.00/hr <br /> CONSULTATION FEE = 57g.00/hr <br /> SAMPLING INSPECTION FEE TOTAL DUE 5 <br /> FOR OFF7CREZ�l'ED <br /> E-USE_ON Y /CASH —RE" IVED d DA E <br /> P-JI TcR�� LC7C DISI <br /> Page <br /> Page 11 <br /> Ex 23 032 (REVISED 4-29-94) <br /> lNv . ba � sd7 <br /> 3 3 <br />