Laserfiche WebLink
SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES - ENVIRONMENTAL HEALTH OIVSION <br /> UNDERGROUND STORAGE TANK PROGRAM - FEE WORKSHEET <br /> S FACILITY SITE NAME FACILITY CONTACT NAME <br /> ' ESTATE <br /> TT OFo HICKINBOTHAM, ET.AL. ATTORNEY BOSCOE <br /> EI gtt. ElSTON AVENUE SITE PHONE X with AREA CODE <br /> a <br /> CITY STATE ZIP CODE 0 of TANKS <br /> A <br /> STOCKTON CA 95203 at SITE ONE <br /> P APPLICANT/B LLING Nand ,APPLICANT CO ACT NAME <br /> L TTORNEY %NALD ll. BOSCOE, AGENT ATTORNEY llONALD D. BOSCOE <br /> 1 <br /> C MAILING ADDRESS APPLICANT PHONE f WITH AREA CODE <br /> N 45 HUNTER SQUARE PLAZA (209) 465 5628 <br /> T ITC I SzzATE ZIR t TYPE of APPLICATION <br /> TOCKTON lA 97UL (closure, Installation, etc.) CLOSURE <br /> TOTAL <br /> 1 1 1 <br /> ANNUAL FACILITY FEE (Prior to January 1, 1991) = 5100.00 1986 1987 1988 1989 1990 <br /> A XXXX %XXX f <br /> C <br /> T FACILITY PENALTY FEES ASSESSED (If Applicable) I XXXX %XXX f <br /> I' <br /> V TANK FEE = S50.00/TANK (Prior to January 1,1991) 5170/TANK (After January 1, 1991) <br /> E <br /> F 4Tatips z ly tt ryoY fee far 11986 11987 11988 1989 11990 11991 11992 11993 ( 1994 11995 11996 <br /> A each year applicable) XXX% ( %XX% I ( I S <br /> C <br /> I TANK PENALTY FEES ASSESSED I XXXX I XXXX I I I I I f <br /> L <br /> 11 STATE SURCHARGE = 556.00 each TANK (Due every 5 years) See California H 3 S Code, Section 25287 <br /> YI t Tanks X 556.00 1988 through 1990 1991 through 1996 <br /> (Enter amount and year) <br />� S <br /> f <br /> `i PERMANENT CLOSURE (Removal or AUthorited Closure-in-Place) I TANK I.O. t(s) <br /> 0 CLOSURE FEE - 578.00/hour (3 hours minima /TANK) I t TANK(s)ONE % S234.00 = f'L3(� <br /> S <br /> U TEMPORARY CLOSURE (Plan Review a Inspections) TANK I.D. t(s) W, lS h <br /> EI TEMPORARY CLOSURE ;E-- = 578.00/hour (3 hours minimum/FACILITY) 5234.00 minimm S / <br /> `I INSTALLATION PLAN CHECK (Plan .Review a Construction Inspections)I TANK I.O. t(s) <br /> AlNPLAN CHECK FEE = 578.00/hour (8 hours minimm/FACILITY) = S624.00 mini mm S <br /> 21 REPAIR FEE (Workplan .Review 3 Construction Inspections) TANK I.D. t(s) <br /> E <br /> Pt TANK LINING REPAIR FEE = 578.00/hour (3 hours minimum/TANK) t TANK(s) _ X 5234.00 = S <br /> A <br /> Ij TANK RETROFIT REPAIR FEE = SMOO/hour (3 hours min./FACILITY) = 5234.00 minimun 5 <br /> R <br /> PIPING REPAIR FEE = 578.00/hour (3 hours mininua/FACILITY) = 5234.00 mini mm S <br /> MI TRANSFER FEE = 520.70 UNAUTHORIZED RELEASE 2VALUATION = 578.00/hr <br /> I <br /> S' <br /> Cl CONSULTATION FEE = S78.00/hr SAMPLING INSPECTION FEE - 578.00/hr I S <br /> TOTAL DUE S9, <br /> 2 .00 <br /> FOR OFFICE USE ONLY <br /> _ SWEEPS t COMPUTER t li LOC CODE I DIST CODE AMOUNT RECEIVED CHECK */CASH RECEIVED 3Y DATE RECEIVED <br /> _H 23 032 (REVISED 10-28.93) Page AS Z <br /> Iftr <br />