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CEJ' r <br /> v <br /> SAN JOAQUIN COUNTY PUBLIC WEALTH SERVICES <br /> ENVIRONMENTAL NEALTN DIVISION , <br /> IANDERGROUND STORAGE TANK PROGRAM • FEE WORKSHEET <br /> FACILITY SITE NAME FACILITY CONTACT NAME JACK DE WITT <br /> CLOLYLNEYRApTpRgU�C�KING CO WESTERN METER SERVICE, INC. E <br /> '46%' NEW1'UN ROAD, SITE PHONE S with AREA COOE(209)942-0191 <br /> CITY STOCK'ION, £T�TE ZIP CODE at SITE Ki 1 X 50000 IallOnB'�0 <br /> 95205 <br /> APPLICANT/BILLING NAME APPLICANT CONTACT WANE <br /> WESTERN METER SERVICE, INC. JACK R. DE WITT <br /> MAILING ADDRESS 2735 TEEPEE DR, STE E APPLICANT PHONE • NIT 209)948E 6124 <br /> CITY CARTE 95205E CLt NSTAALLLATION, etc-REMOVAL <br /> • STOCKTON <br /> TOTAL <br /> 1966 1907 1968 1989 1990 <br /> ANNUAL FACILITY FEE (Pr(or to Janwry 1, 1991) • $100.00 S <br /> TANK FEE 250.00/TANK (prior to Jarwry 1,1991) $170/TANK (after January 1, 1991) <br /> F i Tutu 1986 1967 1986 1989 1990 1991 1992 1993 1994 1995 1996 <br /> A =LtipIY eTiv fes for i <br /> C aach year applicable) <br /> L STATE SURCHARGE • $56.00 each TANK (Due avery S years) $as ca(Ifornle N i S Code, Section 25207 <br /> T f y"s_ z $56.00 1986 through 1990 1991 through 1996 <br /> Y (anter wumt and <br /> PERMANENT CLOSURE (Roaavat or Authorized Ctoeure-ln-Ptscs) TANG I.D. 0(e) <br /> Ca dniau per TANK) TANK(s)_ K $159.00 • i <br /> 0 <br /> U TEMPORARY CLOSURE (A on-tlar paHit, for ravlsw/'nW"tlon) SANK IA. NA <br /> R0 TANK(s) _ K $150.00 0 <br /> E TEMPORARY CLOS(WE FEE • $150.00 each TANK <br /> P PLAN CHECK ((Hatt. Plan Review i Corrtructlon IHpectlom) TANG I.D. 0<s) <br /> L <br /> N PLAN CHECK FEE - $53.00 per hour (6 hours ■Iniac par facltity) • 1424.00 Nlnlaaae e <br /> R REPAIR FEE (workplan review i construction inspection) TANK I.D. 0(a) <br /> P TANK REPAIR FEE • $53.00 per hour 0 hours ■InlssaUTANK) / TANK(s) _ K $159.00 • $ <br /> A <br /> R PIPING REPAIR FEE • $53.00 per hour (3 hour mintmen per facltltY • $159.00) $ <br /> N TRANSFER FEE $20.00 LMMTW*IUD RELEASE EVALUATION • $53.00/hr i <br /> I <br /> C CONSULTATfOM fEE • 553.00/hr SAMPLING INSPECTION FEE • 03.DO/hr S <br /> TOTAL DUE $ <br /> o N Vr 4Q 1 lqr 1 O <br /> EN 23 032 (Revised 4/8/91) - Pape 11 5 <br /> p <br />