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r e - UNDE1R%,.aA1ND STORAGE TANK. PROGRAM - FEE WORKSHEET <br />I <br />I011.1IYYSIIE NAMEAME <br />�----------.-_._._.._..----...----------------------------------IFACILIIY CONTACT )TAME -----------.-___-_- I I <br />' Breuner's. Ron Nason <br />1 - - ---- _ _- _ - --- — <br />I. SIRLEI ADDRESS SITE PHONE I WITH AREA CODE <br />7676 Paci.fi:c- Ave. <br />........ -------- --- -----._.._-- ----- - _ _-----.......—.. --- - -_- --...209-476-8151--- <br />Y CITY STATE i1P CODE I of Tanks <br />Stockton_ _ _CA _95207 <br />at Site ], <br />A APPLICANT/BILLING NAME APPLICANT CONTACT NAME <br />( Trum Bros. <br />11`10.I11G ADDRESS APPLICANT PHONE I WITH AREA CODE <br />1540 Industrial Ave. '--408=292-1201 <br />t! CITY STATE[— <br />TATE ilP CODE TYPE o! APPLICATt01t CLOSURE <br />San Jose CA95112 �CLOOURE. INSTALLATION, ETC. <br />A rnCII.IIY FEE _ 1100.00 each SITE ADDRESS per YEAR TOTAL ;I <br />................_..._._.......__..__........__.... -- - - - _ _.._.. - - <br />... ......... _ -- -- _ _......_.__... - ._...._...._..._...._._....... <br />I �.----13flE----••(-•--•--1981 � --1308 ---1---•-1909 ----f 1----•----- ...__...._ ____ _ 0_.-------• --- <br />1 <br />f . <br />I IAIII' FEE _ $50.00 each TALO: <br />_._....._..._.._.._....._ -- ----....._...._... _ _ _._.... _ ...._.__...._..._... - _ _ - . ........... <br />F I Tanks x t50.00 1986 1907 1988 l38'3 <br />A (E n l t i p l y-1 <br />b y fee for _- -•----...----._-_-. _.---_.__.._.______...._-•-•----_.__._.___.._-_._-------._.....-----•-------•- <br />each year applicable) $ <br />I. SIATE 511RCHAHE = $56.00 each TANK (see CA HEALTH 11 SAFETY CODE Sec 25287 for applicability) <br />I 1 Tanks x 156.00 1906 1381 1308r 1389 <br />Y (enter aiount and year) - --- - ------------_ <br />r t <br />,:IPERMANENT CLOSURE (Removal or Closure -in-place) <br />O CLOSIX FEE = 110.00 each TANKt <br />Tanks 1 x $30.00 f <br />------ <br />P TEMPORARY CLOSURE (Only alloyed one tine for up to two years) <br />... - - -- -- --------- - - - --- -- -_ -- --- <br />MIMPAPY CLOSURE FEE = $00.00 each TAllr. <br />- --- ---.-- .. _. <br />I Tanks x 100.00 e $ <br />----- <br />P PLAN CHECK (installation or Repair) <br />r; <br />11 PLAM CHECK FEE _ $30.00 each SUDMISSION/RESUBMISSION <br />f <br />I... .. _ ...------- -- - -- -- --- --- - - - --- --------- --- --- <br />P TAM: REPAIR FEE 1110.00 each TANK <br />— -- --- <br />I Tanks x 1110.00 <br />-- <br />$ <br />1• ..._....__......_._....... .... _______._.__.__-_-•--------___- <br />A PIPING, P.EPAIP/CLOSUP.E/REMOVAL (Fees are per hour, minimum one hour to be paid on plan submittal) <br />P 1110 1110R17ED R(LEASE EVALUATION <br />CONSTRUCTION INSPECTION <br />SAMPLING INSPECTION <br />(when applicable) <br />When applicable) <br />(when applicable) <br />_ ..- .......... <br />FH _ $30.00/hr <br />FEE = 135.00/hrf <br />FEE = $35.00/hr <br />f <br />TOTAL DUE <br />t <br />orrice usr oNtr <br />SNI FPS I I COMP 1- ILOC CODEI DIST CODEI AMOUNT DUE I AMOUNT RCVD I .CHECK 1/C�l SH I `RCVD BY I_DA <br />'1 11 <br />0 <br />........_._.0 .__.__...._..._..._... <br />90.00 <br />IVEO PERMIT I <br />