Laserfiche WebLink
SAN JOAQUIN C(="TY PUBLIC HEALTH SERVICES - ENVIRODENTAL W-' TN DIVSION <br />l GROUND STORAGE TANK PROGRAM - FEE UORKS(E" <br />5 <br />FACILITY SITE NAME <br />FACILITY CONTACT NAME <br />ILarry <br />T <br />1988 <br />or Hardin <br />1990 <br />CLOSURE FEE _ $78.00/hour (3 hours minimum/TANK) <br />0 TANK(;) 2— x 1234.00 - <br />E <br />t <br />FACILITY ADDREss Rd. <br />1bLt5 Harbor <br />SITE PHONE 0 with 5523REA CODE <br />N <br />PLAN CHECK FEE _ $78.00/hour (8 hours minimum/FACILITY) _ $624.00 mini" <br />S <br />5 <br />A <br />A <br />CITY Stockton, <br />S6 TE <br />l,A <br />iJ �,q)QE <br />y Lll.i <br />/ of TANKS <br />at SITE 2 <br />P <br />R <br />E <br />TEMPORARY CLOSURE FEE - 178.00/hour (3 hours minimum/TANK) <br />1 TANK(s)_ K 5234.00 - <br />C <br />I <br />FACILITY PENALTY FEES ASSESSED (If Applicab(e) <br />xxxx <br />xxxx <br />P <br />APPLICANT/BILLING NAME <br />APPLICANT CONTACT NAME <br />L <br />Paydirt Excavating Co. Inc. <br />Lou Tyedt <br />I <br />C <br />A <br />)AILING ADDRESS <br />269 Oregon St. <br />APPLICANT PHONE K WITH AREA CODE <br />209-599-2347 <br />E <br />/ Tanks a <br />1986 <br />N <br />1988 <br />1989 <br />1990 <br />1991 <br />T <br />CITY <br />Ripon <br />STATE <br />CA <br />ZIP CODE <br />95366 <br />TYPE of APPLICATION <br />(Closure, Installation, etc.) <br />TOTAL <br />C <br />PERMANENT CLOSURE (Removal or Authorized Closure -in -Piece) <br />1986 <br />1987 <br />1988 <br />1989 <br />1990 <br />CLOSURE FEE _ $78.00/hour (3 hours minimum/TANK) <br />0 TANK(;) 2— x 1234.00 - <br />ANNUAL FACILITY FEE (Prior to January 1, 1991) - 1100.00 <br />xxxx <br />xxxx <br />N <br />PLAN CHECK FEE _ $78.00/hour (8 hours minimum/FACILITY) _ $624.00 mini" <br />S <br />5 <br />A <br />U <br />TEMPORARY CLOSURE (Plan Review i Inspections) <br />TANK I.D. N(a) <br />1 <br />TANK RETROFIT REPAIR FEE _ $78.00/hour (3 hours min./FACILITY) • !234.00 mininsm <br />R <br />E <br />TEMPORARY CLOSURE FEE - 178.00/hour (3 hours minimum/TANK) <br />1 TANK(s)_ K 5234.00 - <br />C <br />I <br />FACILITY PENALTY FEES ASSESSED (If Applicab(e) <br />xxxx <br />xxxx <br />PIPING REPAIR FEE - S78.00/hour (3 hours minimum/FACILITY) _ %234.00 minimm <br />S <br />S <br />1 <br />V <br />TANK FEE = S50.00/TANK (Prior to January 111991) <br />$170/TANK (After January 1, 1991) <br />E <br />/ Tanks a <br />1986 <br />1987 <br />1988 <br />1989 <br />1990 <br />1991 <br />1 1992 <br />1993 <br />1 1994 <br />1995 <br />1996 <br />F <br />(multiply 8 by fee for <br />A <br />each year applicable) <br />xxxx <br />xxxx <br />S <br />C <br />I <br />TANK PENALTY FEES ASSESSED <br />xxxx <br />xxxx <br />S <br />L <br />I <br />STATE SURCHARGE - 156.00 each TANK (Due every S years) See California N i S Code, Section 25287 <br />T <br />T <br />R Tanks x 156.00 <br />1988 through 1990 <br />1991 through 1996 <br />(Enter ;Want and year) <br />t <br />C <br />PERMANENT CLOSURE (Removal or Authorized Closure -in -Piece) <br />TANK I.D. $(a) <br />L <br />0 <br />CLOSURE FEE _ $78.00/hour (3 hours minimum/TANK) <br />0 TANK(;) 2— x 1234.00 - <br />f 468.00 <br />P <br />TANK LIMING REPAIR FEE - 178.00/hour (3 hours miniffun/TANK) <br />N <br />PLAN CHECK FEE _ $78.00/hour (8 hours minimum/FACILITY) _ $624.00 mini" <br />S <br />_ <br />U <br />TEMPORARY CLOSURE (Plan Review i Inspections) <br />TANK I.D. N(a) <br />1 <br />TANK RETROFIT REPAIR FEE _ $78.00/hour (3 hours min./FACILITY) • !234.00 mininsm <br />R <br />E <br />TEMPORARY CLOSURE FEE - 178.00/hour (3 hours minimum/TANK) <br />1 TANK(s)_ K 5234.00 - <br />f <br />PINSTALLATION <br />PLAN CHECK (Plan Review i Construction Inspections) <br />TANK I.D. R(a) <br />L <br />A <br />P <br />TANK LIMING REPAIR FEE - 178.00/hour (3 hours miniffun/TANK) <br />N <br />PLAN CHECK FEE _ $78.00/hour (8 hours minimum/FACILITY) _ $624.00 mini" <br />f <br />R <br />REPAIR FEE (Workplan Review 6 Construction Inspections) <br />TANK I.D. N(a) <br />E <br />P <br />TANK LIMING REPAIR FEE - 178.00/hour (3 hours miniffun/TANK) <br />A TANK(,) x $234.00 = <br />f <br />_ <br />A <br />1 <br />TANK RETROFIT REPAIR FEE _ $78.00/hour (3 hours min./FACILITY) • !234.00 mininsm <br />S <br />R <br />PIPING REPAIR FEE - S78.00/hour (3 hours minimum/FACILITY) _ %234.00 minimm <br />S <br />M TRANSFER iEE _ $20.00 <br />CONSULTATION FEE - 178.00/hr <br />N <br />UNAUTHORIZED RELEASE EVALUATION - 178.00/hr <br />SAMPLING INSPECTION FEE - 178.00/hr <br />DIST CODE AMOUNT RECEIVED I CHECK N/CASM <br />S <br />EN 23 032 (REVISED 6-21-93) Page 11 <br />f <br />$ <br />TOTAL DUE 1 <br />RECEIVED BY I DATE RECEIVED <br />5120 <br />3n4�, <br />